Laserfiche WebLink
P�RMIT APPLICATIG��f <br />' CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - vnvw.everellwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDI7 CARDS ARE NOT ACCEPTED <br />��� SITE ADDRESS �� PARCEL TAX I.D. # PERMIT N <br />��� ,z �� 5���-� �^as37y-vdo yyy- v 6 cc�5o�-a��-- <br />i LE,AL LOTNO. BLOCK TRACT <br />� UEti�, n' �I � � , ��- /�/ <br />� ..._�_lro� J'{y _-- /� i � � r _:. �-- � — - .� <br />�, 01NNER ADDRESS GTYIZIP PHONE <br />�� ty ����,�.5 7��_ �� a�x : <br />TENANT NAME CONTACT FOR PERMIT <br />/� <br />— _ ._. ��� ��— <br />CONTRACTOR / ADDRESS <br />(���lcf)'`-J fYL�t17:'1 ,�'-`�'�L <br />CONTR. IICENSE If ('4 `�� <br />� LI u3 /t /7� Cl _T J <br />USE O�UiLDING I HEAT SOURCE <br />�_ ��L <br />, WORK DESCRIPTION <br />� NO. <br />5'% � � > <br />✓s < c i` <br />PLUMBING <br />TYPE OF FI%TURE OR ITEM <br />Toilol <br />[3athWb <br />I-�rv;riorv Gvash basin) <br />Showr.r <br />Kitchen sink 8 disposal <br />Uishwashcr <br />Clolhes washar <br />Laundry tray <br />SinV. �sarvicelbarimop��ic.) <br />�acAllow prevonler <br />Urin;il <br />DnnAmg Fountain <br />Floor drain <br />Gre:�s� lrap <br />Roo( drains <br />Other <br />_ Eluclric� Gus _ Olher <br />� <<� 1 z'�6 <br />5 � -L---�-- <br />PHONE <br />J� ��.� �;�- -.� _ <br />CITY21P PHONE <br />CONTRACI PRICE OF �VORK <br />� <br />MECHANICAL <br />NO. I TYPE OF FIXTURE OR ITEM <br />_ NC - av handlin� units <br />. / Forced air systems <br />�_ Gas pipiny <br />� Walcr hoater <br />_(_. Gas fireplo.:e <br />Gas ran�� <br />�Clothi�s dryor <br />Ranyr. hooi' <br />Exh�usl lan <br />Healpump <br />Unil hoaler <br />Doiler <br />Ralriyeiation <br />Woods�ovo <br />Olhor <br />CITY OF EVERETT LOCAL SALES TAX CODE IS ]t0i <br />� I horoby conlily Ihal I have read and examined Ihis application and hnuw the same lo be Irue and correcL All provisions of laws and <br />urdmaces r�oveminy Ihis lypo of work will bo complied wilh whother specified herein or nul. The yrantiny ol a permit does nol prosume <br />� W yive authority lo violate dr r.an��el Ihe provision ol any other state� or local law regula�ing mnslruction or tho peAormanca o( <br />ronslruclion. Th:d I am autnurirecl by Ihe� owner ol Ilus propehy to pedonn Ih� worA for which applicalion is made and I comply wdh iho <br />� Statc Coniraclorti Law 1H27 RCW ;�ry1 29fi.:UU WAG. • <br />�� J� <br />a�o � (� <br />�� <br />