Laserfiche WebLink
r <br />PERMIT APPLICATION <br />CITY OF =VERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT ii CREDIT CARDS ARE NOT ACCEPTED <br />SITE ADDRESS <br />PARCEL TAX I.D. / <br />PERMIT 0 <br />1515 -15+h &F. SW 5�-_ -I00 <br />1 agogI100 100z00 <br />9Q55P3-crA <br />LEGAL LOT NO. <br />BLOCK <br />TRACT <br />DESC <br />OWNER ADDRESS CITyizIP PHONE <br />CaIweCA 27r6 yW 410Lln it4s L1L PO 6UX k000 �anfTnCi5C0 CA 9441190 <br />TENANT NAME <br />CONTACT FOR PERMIT PHONE <br />GNaT_ic rJeW5 00 � <br />I , im 5iacKburnQr 42-5--7-7s-9-/00 <br />Oa CONTRACTOR Qij ADDRESS CITYRIP PHONE <br />20-7oo ggfh Aue. vJ L1 rinwo6d qZ5--7-7S-a�!oo <br />.f �1 <br />CONTR. LICENSE/ JAVI S51 105 PN b4e- 290 g430310 <br />USE OF BUILDING <br />HEAT SOURCE <br />CONTRACT PRICE OF WORK <br />WQI'Gi'Ious <br />_Electnc Gas Other <br />WORK DESCRIPTION <br />Sy1Sta�i AvJnv\i)0r) L -riOr op J0LtilCiinoJ <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />NO. TYPE OF FIXTURE OR ITEM <br />_ <br />Toilet <br />_ <br />A/C — air handling units <br />_ <br />Bathh-b <br />_ <br />Forced air systems <br />_ <br />La-alory (wLsl basin) <br />_ <br />Gas piping <br />Shower <br />Water neater <br />_ <br />_ <br />Kitchen sink 8 disposal <br />Gas fireplace <br />_ <br />Dishwasher <br />Gas range <br />_ <br />Clothes washer <br />Clothes dryer <br />_ <br />Laundry tray <br />Range hood <br />_ <br />Sink (servicelbarlmop/etc) <br />Exhaust fan <br />_ <br />Backflow preventer <br />Heal pump <br />_ <br />Unnal <br />Unit healer <br />_ <br />Drinking Fountain <br />Boiler <br />_ <br />Floor dram <br />Refrigeration <br />_ <br />Grease trap <br />Woodstove <br />_ <br />Roof drains <br />Other <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3106 <br />1 hereby oenbfy that I have read and examined this application and know the same to be true and correct All provisions of laws and <br />ordinaces governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume <br />Ic give authority to violate or cancel the provision of any other state or local law regulating construction or the performance of <br />construction. That I am authorized by the owner of this property W perform the work for which application is made and I comply win the <br />Slate Cpntractors Law 18. 7 CW11n 296 200 WAC <br />33/ ) 4) .� <br />mat a of Owner/Contractor/Authon_eQ enl atal—> e f�Z <br />