Laserfiche WebLink
SITE ADDRESS <br />LEGAL LOT N0. <br />DESC. <br />OWNER <br />�/� <br />TENANTNAME <br />�'l/� STfi <br />CONTRACTOR <br />CONTR. LICENSE il <br />USE OF BUILDING <br />P�RMIT APPLICATIuN <br />CITY OF EVERETT PERM!T 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 />BLOCK <br />PARCEL TAX I.D. # <br />TRACT <br />ICONTACT FOR PERh71T <br />���%��J �,4//�/ <br />ADDRESS <br />CITY2IP <br />ERMIT # <br />�a�e <br />PHONE <br />(.�L7ZlG 7D � T,�(l� �f C�fiy [�' �1��'7T �'Qy1C�s <br />WORK DESCRIPTIOP! <br />CcaV��7,GGT <br />if/a'Z7�/GflEst <br />HEAT SOURCE CONTRACT PRICE OF WORK <br />Electric _ Gas _ Other � r nm <br />r� "T / X �1 � %�� S%�%��,� I�,_.�n f-w/V I � ` �7'� <br />Cv1ZV�/�G �F F/2E STAT/LNJ �Gb. ,2. <br />NO. I TYPE OF FIXTURc OR ITEM <br />Toilel <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kilchen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (serviceNadmop/etc.) <br />Backflow preveNer <br />U�inal <br />Drinking Fountain <br />Floor drain <br />Grease �rap <br />Roo( drains <br />Other <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C — air handliny units <br />Forced air syslems <br />Gas piping <br />Water healer <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hoo;i <br />Exhaust fan <br />Heat pump <br />Unil heater <br />Boi�er <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 lhe same lo be true and wrrecl All provisions of laws and <br />ordinaces governing this rype of work will be complied wilh whether specified herein or nol The granting of a permit does not presume <br />to give authority to violate or cancel the provision of any other stale or local law reg�ilating consWction or lhe performance of <br />conslruction. That I am aulhorized by the owner of this property lo periorm the work for which applicalion is made and I comply with the <br />Stale Conlractors Law 18.27 RCW and 296200 WAC. <br />