Laserfiche WebLink
P�RMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Gt[)AR STREET, EVERF: i T, WA 98201 <br />425-257-8810 - FAX 425-257-8857 � www.everellwa.org <br />APPLICATIONS ARE ACCEPTED FROIJI 8 AM TO 4 PM <br />SITE ADURESS <br />�t, <br />N9,_ � 6LOCK <br />TENANTNAME <br />PARCEL TAX I.D. p <br />TRACT <br />CONTACT FOR PEHMIT <br />�b �i�-�r.�-. <br />CONTRACTOR � f�' s��� j�` A�DRjs/5��(� �� 1rr <br />��77 � <br />U <br />CONTR. LICENSE N R� Sy �( �' � 5"b L G _ <br />� aJ _ <br />USE OF BUILDING <br />HEAT SOURCE <br />� , , _ Eloctric x Gas _ Olhor <br />NO. I TYPE OF FIXTURE OR ITEM <br />�_ Toile� <br />�a,ir,w� <br />. Lavalory (wash basin) <br />Shower <br />� Kitchon sink 8 disposal <br />� �Isliwasfiar <br />_L Clothos w2sher <br />� 1Netor heater <br />_ SInA (servlce/barhnop/olc.) <br />�ackllew Frevonl�r <br />--- Urinal <br />Ddnking Founlaln <br />Floor dreln <br />Groaso trap <br />� _ Roof dralns <br />Othor ---- <br />PERMIT N <br />CI )V 3 " �0 <br />PNONE <br />�75�7� .�� � <br />CITY2IP PHONE <br />mG�,s���P v�e1�o'J`��O <br />9 �a�o _ <br />CONTRACT PRICE OF WORK <br />N��G /t%�%�% <br />L►J <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C — air handling units <br />Forcod alr systems <br />Gas piping <br />Walor heator <br />Ces Iirepiace <br />Gas ra�go <br />Cb�hes dryor <br />Ranya hood <br />Exhaustfan <br />Heal pump <br />Unit heator <br />Boiler <br />Relrigerellon <br />Woodstove <br />CIN OF EVERETI LOCAL SALEB TAX COD[ IS 7106 <br />I hereby c�rilify Ihnt I hava read nnd exeminad lhis application anC know tho same to he true and corcacl. All provlsions of laws anA <br />ordinacos governing lhls type of worY. will be complied with wholher spucified heroin or not. The gianling of e permit dosa not presume <br />to givo nuRiodty to violate or cancel Oio provision of any other stafe nr la�al law reguleting constniction or lhe peAormance ol <br />cons�ruclion. That I am eulhadzod by Ihe ownar o( lhis pmperty lo porlorm Ihe work for which eppllceUon Is made and I comply with lhe <br />Staln C c ' 18.27 RCW and .280 W�C, <br />�� ��'�°� <br />Signature ol OwnedConlreclorlAuthonmd Agant ate <br />�� <br />