Laserfiche WebLink
S�TE ADDRESS <br />/v4/¢ � <br />LEGAL LOT NO. <br />DESC. � <br />TENANTNAME <br />PERMI� APPLICATION <br />CITY OF FV�RETT PERMIT SERVICES <br />3200 CEDAR STRE[T, EVERETf, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org <br />APFLICATIONS ARE ACCEPTED FROM S AM TO 4 PM <br />BLOCK <br />�c <br />PARCEL TAX I.D. # <br />S'3C'4vo�/4'0/ <br />TRACT OR SUBDIJISION p <br />Qut//A �iir2.lG <br />ADD ESS <br />st.z �-a� sr <br />ICONTACT FOR PERMIT <br />< %/GfAa�— fTl.� <br />�7 <br />PERMIT # <br />��� « <br />PHONE 1 �:�'S/g•�4/3 <br />�� �� /�Lc�aF2iD f� ! U <br />CONTRA TOR nwnwa <br />,[iC.uc' 2/D�E Co�lST. l"/[, 't"�o $05�30� /.7uv�Fcr.- �'igb� <br />CONTR. LICENSE # Zv�' ��' �� 3 <br />%3c.�/�2C1 `18(0�� <br />USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br />S�'!2 I � Electric _ Gas _ Olher ���� ZCD' <br />WORK DESCRIPTION ��S- ie �1�.. — <br />NEo.� � ��Z.11'rrEi� /�o-+.��No+-�s F <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />Balhtub <br />Lavalory (wash basin) <br />Shower <br />Kitchen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />Waler heater <br />Sink (service/badmop/elcJ <br />6ackflow preventer <br />Urinal <br />Drinking Founlain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />����" _'J <br />NO. I TYPE OF FIXTURE OR ITEM <br />I <br />� <br />A/C — air handling units <br />Forced air systems <br />Gas piping <br />Waler heater <br />Gas firep�ace <br />Gasrange <br />Clothes dryer <br />Range hood <br />Exhausl fan <br />Heat pump <br />Unit healer <br />Boiler <br />Refrigeration <br />VVoodstove <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br />I hereby certify lhat I have read and examined lhis application and know lhe same lo be true and correct. All provisions of laws and <br />ordinances governing ihis type o( work will be complied �vith whether speci(ed herein or noL The granting of a permit does noi presume <br />to give authority lo violate or cancel the provision of any olher sta�e or local law regulating construction or the pedormance ot <br />construction. That I am aulhorized by the owner of lhis property to perform the work forwhich application is made and 1 comply with lhe <br />Stale CoMra b w 18.27 RCW�29�.200 WAC. <br />�C.c�� /O •/3 •/c� <br />SionaWre of OwnedCoNraclodAulhonzed Agent Date �'�� <br />