Laserfiche WebLink
l <br />PERMIT APPLICATION <br />CITY OF EVER.ETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE AC "EPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS <br />oS S�k�r Sf=• <br />LEGA LOT NO. BLOCK <br />DESC. �; f''y .iq'� <br />PARCEL TAX I.D. N <br />005� 3:� - 397-oi3-oo <br />TRACT <br />5�� .t,� � c /. 5 l��e�i �io.- <br /># <br />/2 <br />�m +' ��I� {�, ka 1905 S�fe S�. �trfF y8�/ 31�8-�1Soo <br />TENANTNAME I CONTACTFORPERMIT PHONE <br />CONTRACTOR ` <br />��`f�Pr� ��t <br />CONiR. LICENSE # <br />USE OF BUILOING <br />WORK DESCRIPTION <br />I ir�,ko I�.���. <br />ADDRESS <br />;�o�►o i-k f� yh�s 1�; <br />� loi DH <br />I HEA1'SOURCE <br />GTY21P <br />-F✓GYYI q�ob� <br />X Eledric _ Gas _ Other <br />�dr���,r /�1d � �'o•-, <br />NO. � TYPE OF FI%TURE OR ITEM <br />ToilCl <br />Bathlub <br />Lavatory (wash basin) <br />Shower <br />Kilchen sink 8 dis�wsal <br />Dishwasher <br />Clolhes washer <br />Laundry tray <br />Sink (service/badmop/e�c.) <br />Backflow prevenler <br />Urinal <br />Drinlcing Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />O�her _ __ <br />- 3a�- asis <br />PHONE <br />9ar- 3x7-,�S3S <br />CONTRAC7 PRICE OF WORK <br />� .Z l..$GD. oa <br />NO. I TYPE OF I�IXTURE OR ITEM <br />A/C — air handling unils <br />Forced air systems <br />Gas piping <br />Waler healer <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaust (an <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby ceritify that I have read and examined this application and know Ihe same to be true and covect. All provisions of laws and <br />ordinaces governing this type of work will be complied with whelher specifed herein or not. The granting of a pertnit does nol presume <br />to give authoriry to violate or cancel the provision of any olher state or lo�:al law regulaling construction or the performance of <br />conslruclion. Thal I am aulhorized by the owner of lhis property to periorm Ihe work forwhich anplication is made and I comply with lhe <br />Stale Contractors Law 18.27 RCW and 296.20p WAC. <br />� <br />�3=os <br />