Laserfiche WebLink
� � <br />PERMIT APPLICATIGN <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS �'✓p '�7%�� PARCEL TAX I.D. # PERMIT # <br />5 ii %�`�'e,sE6✓E�r% z�a.,�i8-ao -mis�-vo T' �Sb�-l� <br />LEGAL LOT NO. BLOCK TRACT OR SUBDIVISION # <br />DESC. S�� <br />OWNER ADDRESS CITY2IP PHONE Zo - � <br />.¢�v r�a.v y�- •�G `G��R� �il�l J'�'-'�PG. w. s�u,r.�rEo w�a 9d'r.>>� -Y-r..fv <br />TENANTNAME <br />s.4�+� <br />� CONTACT FOR PERMIT PNONE �6� ��9, 4,y�� <br />.-o„�=r vric`�.,z,L ,-,o�✓Y��+tA-Ic�b.tAvE,2Y.Lo.•t <br />E-MAIL <br />/C 4� (/NiTJrri� 4NG. yFj�i3 �%l ��7�E. iG S^lO.MmMLS6� �i'Li � 6%'��� 66Z9 <br />CONTR. LICENSE # <br />WG- �'i fJ Z �'i O <br />USE OF BUILDING <br />/jvsvvEtS /�� �- <br />WORK DESCRIPTION <br />HEATSOURCE <br />_ Eleciric ✓Gas _ Other <br />CONTRACT PRICE OF WORK <br />�fll�f o00- 00 <br />/ZFhrv b��L L�t iJi..�✓� � vi<-�,�iNC'r — vS.i i�as,�✓�sf %'/�-�4 K. <br />'�`/'h oI Oh�G G�U�C�GL'�'/� �4' %L <br />NO. TYPE OF FIXTURE OR ITEM <br />✓ Toilel <br />� b <br />� Laval ry (wash basin) <br />� Sho?ver <br />7 Kitchen sink 8 disposai <br />�Dishwasher <br />Clothes washer <br />7 Water heater <br />Sink (service/badmop/olc.) <br />Backflow preventer <br />rinal <br />Drinking Foun <br />Floor drain <br />Greaso lrap <br />Roof drains <br />Olher <br />N0. I TYPE OF FIXTURE OR ITEM <br />� C—airhandlingunits <br />Forced air systems <br />Gas piping <br />Waler heater <br />Gas tireptace <br />Gasrange <br />Clothes dryer <br />nge haod <br />xhaust(an <br />Heat pump <br />Unit heater <br />Boiler <br />� Retrigeration <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby cerilify Ihat I have read and ezamined this application and know the same lo be true and corract. All provisions of Iaws and <br />ordinaces c�overning this type o( work will be complied with whether specified herein or not. The granting of a pe:mit does not presume <br />lo c�ive authority lo violate or cancel the provision of any olher state or local law regulaling construclion or lhe performance of <br />conslruction. Thal I am aulhorized by lhe owner o( lhis proparty to perform lhe work for which app�icalion is made and I comply wilh the <br />SlateConlracl Law����CW'a/n��6200WAC. �/Z�/O� <br />� /, /i1 <br />i�3 <br />