Laserfiche WebLink
PERMIT APPLICATION <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 - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />SITE ADDRESSPARCEL TAX I.D. # /PERMIT # <br />_ <br />l <br />LEGAL LOT NO. BLOCK TRACT 67,1 vlr- LVC-kZ`-r-r SP 1-4 i2- f -4 <br />DESC. 7 41kiG/J0 jYliC:l2l✓//�D IJ1S+0�-/ 1 v IS . f32— <br />OWNER ADDRESS CITY/ZIP PHONE <br />L�YI«c/an� i m�S �✓�c, p,o, r3cjX 8y8 o�-, SrEvbls '7'2S8 <br />TENANT NAME I CONTACT FOR PERMIT PHONE <br />CONTRACTOR L�4��CC� n✓J f }v hA€ S �N L, ADDRESS CITY/ZIP PHONE <br />CONTR. LICENSE # L,49-t L H I G J) J-L <br />USE OF BUILDING <br />-5 P7 yz- zce�- k <br />WORK DESCRIPTION <br />HEAT SOURCE <br />Electric Gas <br />L.. /3 I C /a3G <br />PLUMBING <br />NO. I TYPE OF FIXTURE OR ITEM <br />3 Toilet / !� <br />Bathtub /1 <br />Lavatory (wash basin) <br />—L Shower / <br />_L Kitchen sink & disposal <br />I Dishwasher <br />Clothes washer <br />Laundry tray <br />Sink (service/bar/mop/etc.) <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />_ Roof drains <br />Other <br />t% <br />CONTRACT PRICE OF WORK <br />Other <br />MECHANICAL <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C — air handling units <br />I <br />Forced air systems <br />Gas piping <br />I <br />Water heater <br />I <br />Gas fireplace <br />_I— <br />Gas range <br />I <br />Clothes dryer <br />I <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />� <br />Refrigeration <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby ceritify 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 />to 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 to perform the work for which application is made and I comply with the <br />State Contractors Law 18.27 RCW and 296.200,VVAC. <br />z/�/��5 <br />ontractor/Authorized Aaent not <br />