Laserfiche WebLink
SRE ADDR�SS <br />� � / CL� �Z i�l <br />LEGAL LOT NO. <br />DESC. <br />OWNER <br />i� ri i 7lc � � <br />TENANT NAME <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREE7, EVERETT, WA 98201 <br />425-257-8810 - FAX 425•257-8857 - vwvw.everettwa.org <br />APPUCATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PARCEL TAX I.D. p <br />BLOCK � TRACT OR SI1801VISION it <br />�ar+ ncroA j�� <br />.S. '�LQ�1L��1(�L `�-� C[a'.WJ <br />CONTA. LICENSE 11 � I� <br />S�l�ti`� N <br />USE OF BUILDING <br />, <br />� <br />I�� �.«c �� � R�,�(' <br />CONTAC/T FOfl PEflMR <br />% FL ��( <br />6 <br />NYIInCJJ � �l <br />'��� l 8`)3�- s% zuP <br />HEATSOURCE <br />_ Electric �Gas _ Olher <br />/a-15 `�d <br />IPERMfT�I <br />I`V� "v`b\ v c Z',> <br />PMONE <br />8ac�l ���= ����=s�sa� <br />PHONE 3G-t.-{� 3``- J35 <br />E�INL <br />� 3G��_�/3�-.73 <br />�`i��3 3 <br />CONTRACT PRICE OF WORK <br />��� C . <br />WORK DESCRIPTION �% � �7 li -�j % � ���� �-yj4�� LL41�� <br />� �"--[�ercF C'_�C'�'�cC, f-rL"Z44C,(�1 lC �- � � <br />( � <br />NO. I TYPE OF Fl%TURE OH ITEM <br />Tailel <br />Balhtub <br />Lavalory (wash basin) <br />Shower <br />Kdchen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />Wator hea�er <br />Sink (servicePoadmoplelc.) <br />Backflow prevenler <br />Urinal <br />Drinking Founlain <br />Floor drain <br />Grease �rap <br />Roof drains <br />Olher_ _ <br />NO. I TYPE OF FlXNRE Ofl ITEM <br />A/C - air handling unils <br />Forcod air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clolhes dryer <br />Fange hood <br />Ezhaustfan <br />Hea� pump <br />Unil heater <br />Boiler <br />Relrigeration <br />Woodslove <br />CI7V OF EVERETT LOCAL SALES TA% CODE IS 3105 <br />I hereby ceritify thal I have read and examined Ihis application and krrow the sama �o be iruo and correcL All provisions of laws and <br />ordinaces governing this type ol work will be complied with whether specified herein or noL The granling of a permil does rwt presume <br />to give au�hority to violate or cancel the provi:;ion of any oiher stalo or local law regulaling consWction or the pertormance of <br />wns�ruction. That I am authorized by lheowner of lhis pmperty ;o pedorm the work for which applicafion is made and I comply with �ho <br />Stalo ContracJ6is I.aw 18 27 RCW and 96.200 WAC. <br />,-�i��ll�( y� `—Y,,��_�,4e(C� -- %C'-/S=�'�� <br />