Laserfiche WebLink
PtRMIT APPLICATIuN <br /> CITY OF EVERETT PERMiT SERVICES <br /> 3200 CEUAR STREET, EVERETf, WA 98201 <br /> 425-257-8810- FAX 425-257-8857 <br /> SITE ADDRESS PARCEL TAX I.D.�1 PERMIT# <br /> � � � b�, �v� �0 3o�-b� <br /> LEGA LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRESS ZIp pHONE <br /> I,�'��e� 1 S u� �-�c�n. �-�-i � �ti'��� �v,� �� 5s' 20l <br /> TENANT NAME CONTACT POR PERMIT PHONE <br /> S��d ��, a� ���ct �-r�� i� ►tit �4�.�, ��� �rs aob;ayo - aoiZ <br /> CONTRACTOR I,� L �y^1�� � ^_�s h ADDRESS 21P CONTR.LICENSE�I <br /> l.L' <br /> PHONE <br /> PROPOSED USE OF BUILDING I Building Mechanicai Addttion HEAT SOURCE <br /> <� �1`-s,� PERMIi � Combination � Plumbing IWORK R Alteration (7 Eleanc <br /> ����'v 1YPE Demolition Sign TYPE D New � Gas <br /> �-�1� �6-�d�'�� Sprinkler U RepaidMaint. Other <br /> CONTRACT PRICE OF WORK CITY OF EVERETT LOCAL SALES TA7(CODE�5 3105 <br /> WORK DESCRIPTION , <br /> l� s `�—C� 3 5�� �,n-�c� 3�w �cs <br /> .. \ �n,L�. i-� U s-e S,�,�1� <br /> PLUMBING MECHANICAL <br /> N0. 7YPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> WATER CLOSET(TOILET) A/C-A/HANDLING UNITS <br /> BATHTUB FORCED AIR SYSTEMS <br /> LAVATORY(WASH BASIN) HEAT PUMP <br /> SHOWER UNIT HEATERS <br /> KITCHEN SINK 8 DISPOSAL CLOTHES DRYER <br /> DISHWASHER RANGE HOOD <br /> LAUNDRY TRAY WATER HEATER <br /> CLOTHES WASHER METAL FIREPLACElSTOVE <br /> URINAL FIREPLACE INSERT <br /> DRINKING FOUNTAIN GAS FIREPLACE <br /> FLOOR DRAIN GAS RANGE <br /> BACKFLOW PREVENTER GAS PIPING <br /> � SINK(SERVICE/BAR/MOP/ETC.) EXHAUST FAN <br /> OTHER OTHER <br /> I HEREBY CERITIFY THAT I HAVE READ AND EXAMINED THIS APPLIGATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br /> PROVISIONS OF LAWS AIJD ORIDINACES GOVERNING THIS NPE OF WORK WILL BE COIdPLiED WITH WHETHER SPECIFIED HEREIN OR I <br /> NOT. THE GRANTUJG OF A PERfd1T DOES NOT PRESUME TO GIVE AUTHORITY TO VIOIATE OR CANCEL THE PROVISION OF ANY OTHER <br /> STHTE OR LOCAL LAW REGULATI.NG CONSTRUCTION OR THE PERFORMANCE Of CONSTRUCTION. THAT I AM AUTHORIZED BV THE <br /> OWNER OF THIS PRQPERTY TO PERFORM THE WURK FOR WHICH APPLICATION IS MADE AND I COMPLV WITH THE STATE � <br /> CONT CTORS LAW 18. 7 RCW AN €�200 WAC. � <br /> --� ' � ! � <br /> SignAt�rC of Ow edContract dAuthorized gent Date <br /> J <br /> DEBIT & CREDIT CARDS ARE NOT ACCEPTED j <br />� <br />