Laserfiche WebLink
SITE ADDRESS <br />LOT NO. <br />TENANTNAME <br />—� S <br />I�`R�11T APPLICATI(�N <br />CITY � i C 1' �;' "�FTT PERMIT SERVICES <br />3200 �,:.,iAR STREET, EVERETT, WA 98201 <br />425-257-tl810 - FAX ,125-257-88F7 — Hr,�w.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PARCEL TAX I.D. # <br />BLOCK TRACT OR S BDIVISION # <br />ADDRESS <br />CONTACT FOR PERMIT <br />� Pn ..� � Ln r;p `$ ( v--n.' <br />f11'�" �� �- � 1'1C_ 2U I%�BG F'�C-f'�ir� <br />USE OF BUILDING <br />i1L'aM I.l)i}- <br />HEAT SOURCE <br />Eleclric Gas OUier <br />PERMIT # <br />_,�ooc�-ao� <br />PHONE ?1(�p -(07 � - � <br />P(d �h0 - <br />3l�0 . G71- / 3 �!j <br />CONTRACT PRICE 01° WORK <br />'� X �'70/1 � O \ <br />WORKOESCRIPTION ►►�1S+G�l,l����n:f�� -����-� S�j� <br />��G�j Cb� ��'t�G cv�c�vco� �iZ� C u: 3�-i�r�cj 1 v Cr�� <br />� %o%C S:�y✓L <br />N0. � TYPF. OF FIXTURE OR ITEM <br />Toilet <br />BathWb <br />Lavalory (wash basin) <br />Shower <br />Kitchen sink & di�posal <br />Disinvasl�er <br />Clothes washer <br />Waler healer <br />Sink (servicelbadmop/elc.) <br />�ackflow preventer <br />Urinal <br />Drinking Founlain <br />Flaor drain <br />Grcase trap <br />Roof drains <br />Olher __ _ <br />O �"1 Cl�� ti� <br />NO. I TYPE OF FIXTURE OR ITEM <br />rUC - air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Cblhes dryer <br />Range hood <br />Exhaustfan <br />Heat pump <br />Unit healer <br />Boiler <br />Refrigeration <br />Waodsrove <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby ceritily that I have read and examined lhis application and know lhe same to be lrue and correcL All provisions of laws and <br />ordinaces goveming lhis type of work will be complied wilh wheUier speci(ied herein or noL The granting of a permit does not presume <br />lo give uthorily lo violale or cancel lhe provision of any clher stale or local law regulaling construclion or the pedormance of <br />co slr tion. Thal I am aulhorized by ihe owner of lhis proporty to perform lhe work for which application is made and I comply with lhe <br />SI �nUaders L�v 18 7 CW a 6.200 WAC. <br />��� e�, - y ,� iv <br />Sig alure of Owner onlractor/Aulhorized Ac�ent Date I` <br />,Y <br />