Laserfiche WebLink
PERMIT APPLICATION <br />CITY OF E�ERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everetiwa.org <br />- - ---- --1 <br />I�SITE AD RESS r�' // APPLICATIONS ARE A PARCELD F�RO�Mp AM TO 4 PM � 1 IT; '%� I <br />t� � <br />j i <br />�, �aPe� P lace�•�e-�e.� �.c- �13g-Ooo-o'l�00/07 -3 � � �i , <br />� lfGAl LOT O. BLOCK TRACT � � <br />I D[SC� % e2 f%� i1y'1 ii' �� J� 1 LV�iL, l��� <br />! NGdA�� �V�zaPmnu�rr�c <br />j TENANT NAME <br />i N�� <br />ICONTRACTOR �O BE A��7�M�NG{� <br />CONTR.LICENSEf <br />USE OF BUILDING �,-�N,� ��. �y,y�i �.1 <br />ReSi de��l Cw��e„;�;a.: <br />lP2lS 7a.�o At/c <br />CONTACT FOR PER�yT, � <br />(,c16l�{ ve t�b�4�r <br />AODRESS <br />HEATSOURCE <br />_ Eier.tnc VGas _ OI!iei <br />WORK DESCRIPTION <br />� L+pNsr�uc-r 1 S1,U�LC G�hni�y <br />I <br />PLUMBING <br />NO. I NPE OF FIXTURE OR ITEM <br />Toilel <br />FJathtub <br />Lavatory �wash basin) <br />Shower <br />Kdchen smk 8 disposal <br />Dishwasher <br />Clo�hes washer <br />Laundry iray <br />Sink Iserncelbar/mop/etc 1 <br />Backllow prevenler <br />Unnal <br />Dnnking Fount3in <br />Flour drain <br />Grease trep <br />Rool drains <br />Other <br />,D.�T�4� � A <br />� �� <br />TYIZIP PMONE y2S'a'Sl��e <br />5 Ka�..r WY� �1Qo3Z <br />PHONE � <br />Y� - ���7Y3S <br />CITVRIP PHONE <br />110� <br />C04TRACT PRICE OF WORK <br />Ly$'f ' <br />� /OS , C4� oc� <br />COIJDOM� N�kw� Uti'�T <br />NO. I TYPE OF FI%TURE OR ITEM <br />NC — a�r hanA� ig unds <br />� Forced air systems <br />� Gas piping <br />�, Water heater <br />� Gas firealace <br />_ Gas range <br />Clothes dryer <br />Rangehood <br />� E■haust �an <br />_ Hea� pump <br />_ Unit heater <br />Boiler <br />� Reingeration <br />Woodslove <br />Othe� <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 7106 <br />I hereby cenhfy Ihal I have read and eaamined Ihis app6cation antl know Ihe same lo be Irue and conecl All provisions ol Wws and <br />ordinaces govemmg this lype ol work wlll be compl�ed with whelher specifieA herein or not The granting of a permd does rr.t p�esume <br />to glve aulhonly to violate or cancel the prowsion of any other state or local law regulating consiruction or Ihe periormance o1 <br />r:onsh,ycUon That I am aidhonzed by the owner ol ihis property to perform the work lor which apphcation is made end 1 comply wilh the <br />3taIt�G6ntr� tors�aw 1 7�W and 296 200 WAC. <br />�/� � <br />� / � /i, � i_nC <br />� r'. <br />� <br />