Laserfiche WebLink
r <br />PERMIT APPLICATION �� <br />CITY OF EVERETT PERMIT SERVICES � <br />3200 CEDAR STREET, EVERE'TT, WA 98201 <br />425-257-8810 — FAX 425-257-8657 — www.everettwa.org <br />J�IC/�YYR;J�\ � � <br />1'1,,� � <br />LEGAL LOTNO. <br />DESC. <br />WNER <br />� �. Q v ��Cl�.� <br />TENA NAry� <br />�-L\, i J: \� �,t <br />�-e�D�( ���`� �� <br />..ONTR. LICENSEi (a �� � <br />l <br />USE F BUILD�NG r � ` <br />�� � C�, <br />APPLICATIONS ARE ACCEPTE�i FROM 8 AM TO 4 PM <br />TAX I.D. k <br />GJJ <br />�,r�.-� �ti\���,���\ ��J���.� <br />I C TACTF <br />`\ � <br />� ADDRE� <br />� �5�� <br />\ <br />P.ERMIT k <br />,� =�v �/, zz <br />4 B �� 1 '�'I� <br />PHONE <br />�� �'���� <br />C�V'L � � C�IO\Q� PHONE <br />��j N 3 � � � � ti�o -�ti� ��1 <br />HEATSOURCE <br />V\1. �n �( � (�r — I _ Electnc _ Gas _ Other <br />� WORK DESC IPTION <br />V� �\ ,�� .� � �\��\\ �\' •���1 ' <br />� <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />Eathtub <br />Lavatory (vrash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Laundry iray <br />Sink (service/bar/mopletc.) <br />BackAow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Olher <br />COI{,TRACT PRICE OF WORK <br />a� �dD:q� <br />NO. I 7YPE OF FI%TURE OR �TEM <br />AIC — air handling units <br />Forced air systems <br />Gas piping <br />� Water heater <br />Gas fireplace <br />Gas renge <br />C�othes dryer <br />Range hood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />Re(rigeralion <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES TA% COUE IS J105 <br />I hereby centify Ihat I have read and examined this application and know the same to be lrue and wrrect. All provisions of laws and <br />orainaces governmg ihis type of work will be complied with whether specified herein or noL The granting of a permit does not presume <br />to give authonty to violate or cancel the pmvision of any other state or local law regulating construction or the perfortnance of <br />constr� ction. That I am authorized y the owner of Ihis propeAy to perfo the work tor which application is made and I comply with the <br />Sta�clConhactors law 1827�RCW�id 296200 WAC. � � <br />Q.�-ow� <br />��2 <br />