Laserfiche WebLink
�tRMIT APPLICATI�N <br /> CITY OF EVERETT PERMIT SERVICES <br /> � 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810— FAX 425-257-8857 <br /> � <br /> SITE ADDRESS n PARCEL TAX I.D. # PERMIT p <br /> �v,� Z �' . Po3o9-0� � <br /> ' LcG%.: LOT NO. BLOCK TRACT <br /> OESC.r <br /> ! OWNER ADDRESS ZIP PHONE <br /> i <br /> � TENANTNAME I CONTACTPORPERMIT PNONE <br /> � CONTRACTOR ADDRESS 21P CONTR.LICENSE# <br /> I <br /> � PHONE� /, ) <br /> (/L/ C <br /> � PROPOSED USE OF BUILDING Building � Mechanlcal Addition HEAT SOURCE <br /> � PERMIT Combination PlUmbing WORK Alteration [� ElecUic <br /> ', TYPE Demolition Sign TYPE New �] Gas <br /> � Spnnkler RepairlMainl U Other <br /> � CONTRACi PRICE OF WORK C!TY OF EVERETT LOCAL SALES TAX COOE IS�705 <br /> i WORK DESCRIPTON • <br /> � L'W/ I��L/! /�--i" L��/�� � ����Gl�Vc-t'� i��/-�"'^��C./ <br /> �� <br /> LUMBING MECHANICAL <br /> , NO. I TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURF.OR ITEM <br /> ' WhTER CLOSET(TOILET) A1C—AIHANDLING UNITS <br /> ' BATHTUB FORCED AIR SYSTEMS <br /> LAVATORY(VJASH BASIN) HEAT PUMP <br /> SHOWER UNIT HEATERS <br /> KITCHEN SINK E DISPOSAL CLOTHES DRYER <br /> DISM�VASHER RANGE HOOD <br /> _ LAUNDRY TRAY WATER HEATER <br /> � CLOTHES WASHER METAL FIREPLACE/STOVE <br /> URINAL FIREPLACE INSERT <br /> �RINKING FOUNTAIN GAS FIREPLACE <br /> PLOOR DRAIN GAS RANGE <br /> 9ACKFLOW PREVENTER GAS PIPING <br /> SINK(SERVICElBP.R/b10P/ETC.) EXHAUST FAN <br /> OTHER OTHER <br /> � HEREBY CERITIFI'THhT i HAVE READ PND EiWtAINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br /> �ROVISIONS OF IAWS lJJD ORIDII�iAC�S GUVERNING THIS TYPE OF WORK N/ILL BE COMPLIED WITH WHETHER SPECIF:ED HEREIN OR <br /> .'�OT THE GRANTiNG OF A PERtd1T OOES N07 PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHeR <br /> STATc OR LOCl.L LA4Y REGULATI�lG CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED 8Y TNE <br /> O'l1NER O THIS PROPERTY TO PERPORtd THE WORK FOR WHICH APPLICATION IS PdADE AND I COMPLY WITH THE S7ATE <br /> � CO' TRi. i ORS � 18.27 RCLY AND 296.200'NAC. <br /> o �2S=d <br /> Si - re of ner/ContracroUAuthonzetl Agent Data <br /> DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />