Laserfiche WebLink
PtRMIT APPLICATI(�N <br />CITY OF EVERETT 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 <br />SITE ADDRESS <br />�; � -� <br />LEGA LOT N0. BLOCK <br />DESC. <br />OWNER <br />l <br />''`iti� ���i( �fJ,�(ll ��'� <br />NANT NAME <br />i!! • ✓1 <br />CONTRACTOR <br />� ^ / <br />^.ii7^. LICENSE N C-� �-'�V <br />USE OF BUILDING <br />PARCEL TA7( I.D. N <br />TRACT <br />FOR PERMIT <br />ADDRESS <br />' rcT <br />CITV2IP <br />N <br />_ ,' <br />ydS •�/S'�iJe <br />PHONE <br />_ HEAT SOURCE I CONTRAC7 PRICE OF WORK <br />Eledric Gas Olhor <br />WORKDESCRIPfION ..� . �/��� ^� <br />,. �5 G.1"I7Lt� ..�%ll�� �� ' <br />NO. � YPE OF FIXTl1RE OR ITEM <br />ilot <br />r pMhlub <br />I Lovalory (wash basin) <br />howcr <br />__ Kilr.hen sink 8 dis{wsal <br />luthes watihoi <br />: Wator he�tor <br />_ � � Sink (servlcoN2r/mop/�Ic.) <br />�ackflow pre.venter <br />Urinal <br />Diin!cing Founlain <br />Floor drain <br />Greasetran <br />Hoo� drains <br />Olhor <br />� <br />NO. I TVPE OF FIXTURE OR ITEM <br />NC - air handliny unils <br />Forced air syste.ms <br />Gas piping <br />� _ W ator hoatar <br />Gas fireplace <br />asranc�o <br />� Clolhes dryer <br />�nc�e hood <br />� Exhaus� fan <br />_ Hoat pump <br />Uni� hoatar <br />Boilor <br />Relriyeralion <br />Woodsto+e <br />Olher <br />CITY pF EVERETT LOCAL SALES TA%CODE IS 7705 <br />I here[ry cr.ri�ily ihal I have read anA examined Ihis appliwtion and know Ihe same to bo Iruo and correr�. All provisions o/ laws and <br />nrdinacns govmnine� Ihis Wpn ol work wtll be comyiioJ �.vilh whethor specified hr.rein or noL The granting ol a pormif doos not presume <br />to �ive aulhorlly lo violate oi cancel thA provisio� ol any othor state or local law ro�ulating const�uction or the pedormance ol <br />ons�ruclion. Thal I am aulhorized by Iho owner of Qiis property to peAomi lhe work lor which apotication Is made and I comp.y wllh the <br />S�ate Conlraclors Lew 18.27 jtCW anA 296.200 WAC. <br />� ;=,,;, ���i,i�% �' -� � �� <br />Si�nalure of OwnedContr ctor/ ul oriz�� Dato <br />