Laserfiche WebLink
SITE ADDRESS <br />;91� �12*� <br />LEGA LOT NO. <br />DESQ (_ <br />So N..a( <br />NAME <br />CONTR. LICENSE f1 <br />USE OF BUILDING <br />WORK DESCRIPTION <br />PEI�iJIIT APPLICATION <br />CITY OF EVERETT PERMIT SE�ZVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FfX 425-257-8857 — wwv+.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PARCEL TAX I.D. p <br />F <br />PERMIT p <br />mo5 „_ <br />BLOCK TRACT <br />(�U£(L$"� nJ% <br />ADDRE55 CITY2IP PHONE �,�I���u _� <br />a� E✓r-rfh ?'f1 S 9G "—' P� , s� E�6z&T, wR 43zc�r <br />I CONTACT FOR PEHMIT PHONE <br />,�uT7Sn1 G- 'iEST <br />PLUMBING <br />� <br />AODRE35 <br />HEATSOURCE <br />_ Elec�n� ' Gas _ Olher <br />QO �ls _ <br />CITY2IP PHONE <br />c7N �JGt$ iTN Cr C—A-1 Rrlo�. <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilel <br />Balhlub <br />Lav�lory (wach hasin) <br />SIIOKOf <br />Kilc`�an s nk 8 disposal <br />Dishwasher <br />Clolhos e�asher <br />Walor he:�tor <br />Sink (servi��o/bar/mop/c�c.) <br />Backflcw prevonlor <br />Urinal <br />� Drinking founlain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />CONTRACT PRIf E OF WORK <br />NO. I TYPE OF FIXTURE OR IT[M <br />NC - air handling unils <br />�orced eif syslam5 <br />-Gas piping p N Lv� <br />Water heator � <br />Gas (ireplace <br />Gas range <br />Clolhes dryer <br />Ranga hood <br />Ezhauslfan <br />Hoatpump <br />Unil healr.r <br />P.oiler <br />Refrigerati�n <br />Woodstove <br />Other___ <br />CITY OF EVERETT LOCAL SALES TAX CODE IS �105 <br />I htreby cerilify that I have read and examined this apnficalion and know the same to be true and cortect. All provisions ul laws and <br />crdinace: qoveming this type ol work will bo complied wilh whether specilied herein or nol. The granling of a permit does nol presume <br />lo givc au�hor':y Io violate or cancol Iho provision of any other state or local law regulalin{� wnstruclion or the pertormance ol <br />construction. Thal I am aulhorized by ihr owner ot lhis property to perlorm lhe work tor which application Is made a.id I comply with lhe <br />Slate Conlractors Law 18.27 RCW and 2�36200 WAC. <br />Signature o OwnedConlractodAuthorized Agent Date <br />