Laserfiche WebLink
P�r�MtT APPLICATIG,� <br />CITY OF EVERETT PERMIT SERVICES <br />320Q CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — F/�X 425-257-8857 — www,everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 FM - DEBIT & CREDIT CAR�S ARE NOT ACCEPTED <br />SITE ADDRESS PAS;CEL TAX I.D. # <br />��� �3 i I•TM� s�,--��-.� a-��U�3y��.�2 P��T� j <br />LEGA LQT NO. BLOCK ,T.F%tACT / <br />OW ER �OID D-Dz �'° ID���I-a7TS I� IS� � ( �}� �,�Iy'y,,y�"� <br />ADDRE55 ` � '"l'^4� - ''"-'—' S) <br />CITY21p PHONE <br />�tfYJ ��vtSs� �`�II .Si��'' STS`c- �/�� " '�`-} D', <br />TENANT NAME I CONTACT FOR PERMI f � ���� � <br />',���� 1 Sr1�'I�C PHONE <br />CONTRACTOF - <br />CONTR. LICENSE # <br />uac �r t3UIL�ING <br />cy�_ <br />waRK DESCRIPTION <br />LY1 � ADDRESS <br />HEATSOURCE <br />_ Electric �Gas _ Other <br />�tPP�, 2 'r-o�w'hnT� o� -F j.c.Y�F <br />NO. I TYpE OF FIXTURE OR I7EM <br />iouet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />Laundry tray <br />Sink (service/bar/mop/etc.) <br />BackOow praventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />� <br />��TYrz�P PHONE <br />CO TRACT PRICE OF WORK <br />��� <br />TYPE OF FIXTURE OR ITEM <br />tv� — au nantlling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />Other <br />CITY OF EVERETT LOCA� SALES 7AX CODE IS 3105 <br />I hereby ceritify that I have read and examined ihis application and know the same to be trua and correct. AII provisions of laws and <br />ordinaces governing this lype of work �vill be complied with whelher specified herein or not. The granting of a permit does not presume <br />to give authorify to violate or cancel the provision of any ofher state or local �aw regulating consiruction or the p�rformance of <br />construction. Thai I am authorized by th� owner of this property to perform the work for which application is made and i comply wilh the <br />Stale Contractors 18.27 RCW and 296.200 WAC. <br />.. '_ bclss.� b3�Oi�e� <br />1 Ya � <br />r- -- :- .. <br />