Laserfiche WebLink
PERMIT AP�`�LICATION <br />CITY OF EVERE f T PERMIT SERVICES <br />3<00 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.evereuwa org <br />APPLICATIONS ARE ACCEPTE� FROM 0 AM TO 4 PM /JI� IC� _ v� <br />-- -- -- — � 6 _ _ 1 -- - <br />SITE AD�RESS pARCEL TAX I.D. # I PERMIT il <br />ia s� 3 %%''`'�✓� 5� �'✓wwf- �/D_6_�7 aaoo a c ov_ _ � �;_lc' i_;.� . G��� . � <br />LEGAL LOT NO. BLOCK TRACT R SUBDIVISION q '/ � � �i <br />DESC. �j �y-�cX�- GA�c:! C��7../`.Gf GO% 6 � <br />OWN AD'JRESS � CI7Vl'LIP PHONE <br />lL�} j I <br />�P1//.�,�. _ Po Box_ 7%r%(i� /i it�ir'c`ti/%��Ck� �iZ�-%/�s'f.3.3 <br />- ! / <br />TENANTtJAME CONTACTFORPERMIT � PHbNezo�-(,G�j-%5�3 � <br />�D�i�J'/ ��!lN� E�MAIL6/Ll6✓l'f�n.K+. �% ni� �im <br />CONTRACTOR qDDRESS � � CINiIIP PH N� —�--- � <br />�l�'�e��r .rJr�, �� Po Bo,� Zia6 avnt�'i�/`�Foy/ Zv�-G� �-�y�,T� <br />CONTR. LICEFSE u � '� <br />_L�/-,'�'r.¢i✓ii13v Di< — --- - -- — <br />USE OF BUILDING � HEAT SOURCE I CONTRACT PRICE OF WORK � <br />C�iNe�s' <br />WORK DESCRIPTION <br />�,«S�/s<�.Y;.n <br />_ Electnc �Gas _ Olhei <br />.� n LIL� o � Pr <br />��G �3 J <br />NO. I TYPE OF FIXTURE OR ITEM <br />TOiIC� <br />BalhWb <br />Ladatory (wash basm) <br />Shower <br />Kitchen sink 8 disposal <br />Dishwasher <br />Clolhes washer <br />VJater healer <br />Sink (serncelbar/moplelc.) <br />Back�mv prevenler <br />Unnal <br />Drinking Founlain <br />Flcor drain <br />Grease trap <br />Roo( drains <br />Other _ _ <br />-��-. rt�i f=z„-, . � %�cr � da����.v� <br />�, / � <br />.. �i�. +;� _ <br />MECHANICAL <br />NO. I TVPE OF FIXTURE OR ITE1d <br />NC - dir h�ndhny unds <br />� Forced air systenu <br />_,� Gas pipin� <br />,� Wa�er heafEr <br />� Gas (ireplace <br />Gas range <br />� Clolhes drym <br />�Range hood <br />Exhausl fan <br />Heal pump <br />Umt heater <br />Boiler <br />Retrigeradon <br />Woodstove <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certify Ihat I have read and =xamined this applicalion and know !he same lo he Irue and correct All provisions of laws and <br />ordinances goveming this type of work will be complied wilh whelher specifed herein or nol. The granting ol a permd does nn! presurne � <br />to give authonty lo violate or cancel the provision of any other slate or local law regWat�ng consUucucn ur Ihe perlormance o( �. <br />constryyuon. Tha1 I am authorized by the owner of Ihis propeity lo perform Ihe vfork f�r which applicauun :s made and I comply vrith thc ' <br />Stateiihntracto[s La�v.Y8.27 RGW and 296.200 4VAC. � <br />l9 <br />