Laserfiche WebLink
SITE ADDRESS <br />�f�/s �ilv <br />LEGAL LOT NO. <br />�SA�A io�so� <br />TENANTNAME <br />/, �it <br />PCRMIT APPLICATIUN <br />CITY OF EVER�i'T PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.everettwa.org <br />APPLICA710NS ARE ACCEPTED FROM 8 AM TO 4 PM <br />� <br />BLOCK <br />��is <br />PARCEL TAX I.D. # <br />TRACT OR SUBDIVISION p <br />J� �-G�t�,i� l.�u <br />CONTACT FOR PERMIT <br />conTPqcioH � i auuHesa <br />� /uen.v; ��� Ser i%,'��s .Zile . <br />CONTR. LICENSE # ' <br />USE OF BUILDING <br />WORK DESCRIPTION <br />NO. I TYPE OF FIXTURE OR ITEtd <br />Toilel <br />Balhtub <br />Lavalory (wash basin) <br />Shower <br />Kilchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (servicelbar/mop/elc.) <br />Back(low oreventer <br />Urinal <br />Drinking Founlain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />HEATSOURCE <br />Eleclric Gas Olher <br />PHONE <br />CONTRACT PRICE OF WORK <br />NO. � TYPE OF FIXTURE OR ITEM <br />A/C — air handling unil; <br />Forced air syslems <br />�,Gas p:ping <br />Water heater <br />�/ Gas fireplace <br />Gas range <br />Clolhes dryer <br />Range hood <br />Exhaust (an <br />Heat pump <br />Unil heater <br />Boiler <br />Refrigeration <br />Woods�ov��4 <br />✓ Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby c�rilify thal I have read and examined lhis application and know lhe same to be lrue and correcL All piovisions of laws and <br />ordinaces goveming lhis lypr, ot work will be complied with whelher speci(ied herein or nol. The granting of a permit does nol presume <br />lo give authority to violale ur cancel the provision of any other stale or local law rec�ulating construction or ihe per(ormance of <br />consUuction. That I am aulhorized by Ihe owner of this properly to periorm the work for which applir.ation is made and I comply with Ihe <br />Slate Contractors Lav� 1f1.27 RCW and 296.200 WAC. <br />�I����� o� <br />