Laserfiche WebLink
SITE ADDRESS <br />�13 I� <br />LEGA LOT NO. <br />DESC� <br />F-CRMIT APPLICATI�N <br />CITY OF �b'ERETT PERMIT SER`✓ICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.everettwa.ory <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />/" ,'-- PARCEL TAX I.D. # <br />l8 "' ,�4✓e CJ ��� D /D �/G70lIDr <br />BLOCK I TRACT OR SUBDIVISION # <br />FT #� <br />�'' C?� , <br />OWNER AODRESS CITYIZIP PHONE Y2f^ <br />/�.(,���r C,��f �� r�� ,���.� �� G�`�s' s„d��„s� �v � <br />TENAN'f NAtdE I CONTACT FOR PERMIT FHONE <br />r1o� a,�� E�MAIL <br />t� ca,.�,-�. �f:ti <br />CONTR. LICENSE # <br />L� <br />USE OF BUILDING <br />WORK DESCRIPTION /���,� ��� <br />NO. � TYPE OF FIXTURE OR ITEM <br />Toilel <br />Bathtub <br />Lavarory (wash basin) <br />Shcwer <br />Kitchen sink 8 disposal <br />Dishwasher <br />Clolhes washer <br />Water heater <br />Sink (servicelbar/mopletc.) <br />Backllow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roo( drains <br />Olher <br />QcsG� /� /yll.vf,f/i/ . ..- j6'D� <br />HEATSOURCE <br />Eleclric 1Gas _ Other <br />NO. <br />CONTRACT PRICF OF WORK <br />Mtl:F1ANIl:AL <br />TYPE OF FIXTURE OR ITEM <br />A/C — air handling unils <br />Forced air systems <br />Gas piping <br />Waler heater <br />Gas fireplace <br />Gas renge <br />Clothes dryer <br />Rangehood <br />Exhausl fan <br />Heat pump <br />Unit heater <br />Boilet <br />Refrigeration <br />Woodstove <br />CITY OF EVERETT L.00AL SALES TAX CODE IS 3105 <br />I hereby ceritify that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br />ordinaces governing lhis lype of work will be complied with whether specified herein or not. The granting of a permit does not presume <br />to give aulhority to violate or cancel the provision of any other state or local law regulaUng conslruclion or the pennrmance of <br />construclion. That I am authorized by lhe owner of this property to perform the work for which application is made and I comply with the <br />State Contractors Law 18.27 RCW and 296.200 WAC. <br />