Laserfiche WebLink
SI7E AUDqESS <br />LOT Nn. <br />Df-S.;. <br />PERM�T APPLICATION <br />�ITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STFIEET, EVERETT, WA 98201 <br />d25-257-8810 - FAX 4'%5-257•8857 - www.everettw� .org <br />APPLICATIONS AHE ACCEPTED FFIOM 8 AM TO 4 PM <br />PARCEL TAX I.D. R �RMR �,{ �j . <br />( j �1 , l /,. -� . , ---- `--l"JCI (:0 l�l: � <br />J1_ <br />7AACT OR SUBD�VISION f <br />� 4 1 <br />II �. �-�. •�r � !�i'�.e � (.� .,ri���'� � <l�i ��(�v � _ <br />'�C;�r� ���. �'� � �, -�:�/ � I'�C�i��i.�� i�i �� I C v�.P11 ��P1��� ����; lll ?.21��— <br />,��. � - � •� � � - <br />TENANT NAME I CONTACT FOR PERMIT PHOME � i i !�.. � �%� �C X�i�'R: <br />.� i <br />�— �.it�,l��li �r",i�ei'��_ E41AIL�, �,'.1..._��nl:.l°H��. <br />bVI�lI1MM��/�l � � r.. �. ., 1'� l ( � �. �' �' . �� <br />��k ,,, ��,� �. � � „��� �� .��� <br />.�.. �• n . <br />CONTR. LICENSE M'` .- _ � �, ., i <br />.1' • � L -'� 1 r�'r�, <br />USE OF BUILDING I HEAT SOURCE <br />�„��� ����I��i� <��i..�IVtI(r..�o <br />,I El�dric Gas Olher <br />I.. �n,�v _. - <br />WORK DESCRIPTION <br />� <br />,"i,�''4�r�`� J . , � <br />NO- TYPE OF FlXTURE Ofl REM <br />Tui�a� <br />�� �athtub <br />Lava�ory (wash basin) <br />� Shower <br />Kdchen sir.k 8 dis{�sal <br />� �ishwasher <br />Clothos washer <br />_3,, Water healer <br />Smk (sorvice/badmop�nlr..) <br />' Bar.kflow preveNer <br />Urinal <br />Drinking Founlain <br />Floor drain <br />Cirease Irap <br />� Roof drains <br />_, Olhor <br />� � �, i 1 1 <br />I CONTRACT PRICE OF WpRK <br />NO. I TYP� Of FlXTURE OH I'fEM <br />NC - air hardling units <br />� Forcc+d air systems <br />�'� Gas piping <br />( Vla;oi healer <br />( Gas firopince <br />Gas range <br />_J _ Clothesdryer <br />� Range hood <br />y Exhaust tan <br />Hoatpwnp <br />. Uni� healer <br />Boiler <br />Helrigen �n <br />Woodstavd <br />.. Other----_-- ----. . <br />CITY OF EVEflETT LOCAL SALES TA% CODE 19 3106 <br />I hereby ceniity tl�at I he�e read and ex. mined ihis epplicalion and krww Ihe same ro be irue arnl wtrect. All pruvisions ol laws and <br />ordinaces governing Ihis type ol work will be complied wilh whalhe� specified heruin oi nol. 1'he prantin� of e perm2 daes nol presume <br />tu give aulhority lo aolate or cancel the provision pl any olher stete or local law reguleBng r,onslNctlor ur Ihe peAOrmance of <br />consVuclion. Thot I am euthorized by the owner o( this propedy to pedorm the work lor which applirsttion is made and I wmply with tho <br />61ata Conlradors Law 18.27 RCW and 29G200 WAC. <br />�'', <br />� __ ��i'�I��f ��,.�'��I �� <br />S`ignalu�e o er ontraclor ut oriz genl ,�— - � <br />c_ <br />ma <br />