Laserfiche WebLink
M <br />P�RMIT APPLICATIt�N <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAP. STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org (� � 1�,/� . l� <br />`/ J <br />� <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />SITE ADDRESS <br />N0. <br />�,� � jE <br />BLOCN <br />PARCEL TAX I.D. G <br />O � 4"9;�2 - a� <br />U�� <br />Y- alL - oL <br />- �� <br />k� yK a.r�y �o�c�J ..Z.,,,G Po �3dX 7/L �� L�y -y<T ZSa ?�Pj <br />TENANT NAM�.�— I CONTACT FOR PERMIT PHONE <br />� c f-F G ra y v�r- yz L-�Gy� <br />CONTRACTOR Qy/qq/fv �f0%.� ,�j��AOURESS f� �, CITY2IP PHONE <br />r <br />CONTR. LICENSE N j J� h 41'�i /i ��T <br />USE OF BUILDING <br />s F� <br />WORK DESCRIPTION <br />Cc�kS'�l"u` �.on <br />N0. � TYPE OF FIXTURE OR ITEM <br />� <br />/ <br />Tailat <br />Bathtub <br />Lavatory (wash basin) <br />Shawer <br />Kitchen sink & disposal <br />Dishwaeher <br />Clothes washer <br />Laundry tray <br />Sink (servicelbadmop/etc.) <br />Bsckllow prevanter <br />Urinal <br />Dnnking Fountain <br />Flaor drein <br />Grease lrap <br />Roof drains <br />Other <br />HEATSOURCE <br />Electric �Gas _ <br />� f T�'K <br />r.L.71 <br />CONTRACT PRICE OF WORK <br />ocner �'�o, o o � <br />�a'-a /oSd -�jw'a�l� <br />y7� <br />i-'' <br />TYPE OF FI%Tl1RE OR ITEM <br />A/C — air handling units <br />Forced air systems <br />Gas piping <br />Water healer <br />Gas fireplar,e <br />Gas range <br />Clothes dryer <br />Ranye hood <br />Exhaustfan �� <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeretion <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE I� 710! <br />I nereby centi(y that I have read and examined this applicatnn and know the same to be true and correct. AII pravisi.ms of laws and <br />orAinaces governing Ihis type ot work will be complied with whether specified herein or noL The granting of a permit does nol presume <br />m prve authonty to violale or cancel Ihe provision of any other state or local law regulating construction or the peAormance of <br />construction. That I am authonzetl by the ewner of this property m per�orm the wurk for which application is made and I comply wdh the <br />State Contracto� Law 18.27 RCW and 2�200 Wi�C. , <br />— 'h <br />.jtl `� d � � <br />