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 <br />SITE ADDRESS <br />PARCEL TAX I.D. # <br />PERMIT # <br />LEGAL LOT NO. <br />BLOCK <br />TRACT <br />DESC. <br />OWNER ADDRESS ZIP PHONE <br />TENANT NAME <br />CONTACT FOR PERMIT PHONE <br />��ff C/ <br />Brtas-- L 4 <br />` z, ' n 1 b <br />CONTRACTOR ADDRESS ZIP CONTR. LICENSE # <br />3s�L5�� <br />PHONE <br />PROPOSED USE OF BUILDING <br />FErgiuilding m[�'�echanical <br />tion <br />HEAT SOURCE <br />PERMIT <br />ombination U Plumbing <br />WORK <br />Electric <br />TYPE <br />Demolition U Sign <br />;Alteration <br />TYPESprinkler <br />air/Maint. <br />U Other <br />CONTRACT PRICE OF WORK /T2jl -� <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />WORK DESCRIPTION <br />LC <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />NO.. TYPE OF FIXTURE OR ITEM <br />3 <br />WATER CLOSET (TOILET) <br />A/C - A/HANDLING UNITS <br />BATHTUB I <br />i <br />FORCED AIR SYSTEMS <br />LAVATORY (WASH BASIN) <br />HEAT PUMP <br />a,. <br />SHOWER (t <br />UNIT HEATERS <br />KITCHEN SINK & DISPOSAL <br />�_ <br />CLOTHES DRYER <br />J— <br />DISHWASHER_ <br />RANGE HOOD <br />LAUNDRY TRAY <br />WATER HEATER <br />_ <br />CLOTHES WASHER <br />METAL FIREPLACE/STOVE <br />URINAL <br />FIREPLACE INSERT <br />DRINKING FOUNTAIN <br />�_ <br />GAS FIREPLACE <br />FLOOR DRAIN <br />GAS RANGE <br />BACKFLOW PREVENTER <br />GAS PIPING <br />SINK (SERVICE/BAR/MOP/ETC.) <br />EXHAUST FAN. <br />OTHER <br />OTHER P-41- <br />I HEREBY CERITIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br />STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br />&"Jak_bl� -_'��A 7t--3t 6 <br />Signatuile of Owner/Con a or/Authoriz d Agent Date <br />DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />