Laserfiche WebLink
P�RMIT APPLICATIrN <br /> CITY UF EVERETT PERMIT SERVICES � <br /> 3200 CEDAR STREET, EVERETT, WA 98201 I <br /> i 425-257-8810- FAX 425-257-8857 ' <br /> � <br /> I SITE ADDRESS PARCEL TAX I.D.# PERMiT z <br /> ;�� �� r �� � , <br /> /4 / h.o � � Ja. ,, � <br /> � L'cGA LOT N0. LOCK TRACT I <br /> I; eesc. q — `� ��� 5 <br /> ; OWNER ADDRESS 21P PHONE I <br /> � �� � � � ��S � . hro,�� . ��. ��24n���i�5 ltilAL�SSeL' �.4I0�3 �10/- '�4'S �b'•1')���� <br /> f o� � --bltr �qL. <br /> , TENANiNAME CONiACTFORPERMIT PHONE <br /> ���-Iv 2o �tie. _ I ��/.�c � � �j���,-��� ����-5 �9 -�� 7q� <br /> i CONTRACTOR f L ADDRESS ZIP CONTR.UCENSE X <br /> i �JiC11'I �� GF"� - ���LI�' �L .�"3 �rJ�� . � ��'��1h. s ' _z jLynf� �L�/Sd��� <br /> J /� <br /> , PHONE ���3 -�(7�I �O�'`� �0 I�tG� YGC�� W�.A�{. (.�l� � �C.YI J <br /> _ _ � i <br /> , PROPOSED USE OF BUILDING � Building Me�hanical Addition HEAT SOURCE <br /> � ✓� /"� ) PERMIi Combination �mbing WORK R Alteration � Etectnc <br /> y7 � TYPE Demoiition Sign ivpe D New Gas <br /> Sprinkler U Repair/Maint. Other <br /> CONTRACT PRICE OF WORI< � "J�,L.�, �'O CITY OF EVERE7T LOCAL SALES TAX CODE IS 3105 I <br /> i <br /> � 4VORK�ESCRIPTION � <br /> ; � ,��,z.i r (.�) �.)«i� �,����,��I s;��,s i (, ) �yl�,� ��,�►� I <br /> I <br /> PLUMBING MECHANICAL <br /> �� NO. TYPE OF FIXTURE OR ITEM N0. TYPE OF fIXTURE OR ITEM � <br /> I I_ WATER CLOSET(TOILET) A!C-A/HANDLING UNITS <br /> _ BATHTUB FORCED AIR SYSTEMS <br /> _ LAVATORY(WASH BASIN) HEAT PUMP <br /> , _ SHOVJF_R UNIT i�EATERS <br /> _ KITCHEN SINK 8 DISPOSAL CLOTHES DRYER <br /> _ DISHIh'ASHER RANGE HOOD <br /> _ LAUNDRY TRAY WATER HEATER <br /> _ CLOTHES WASHER METAL FIREPLr10E/STOVE <br /> _ URINAL FIREPLACE INSERT <br /> _ DRINKING FOUNTAIN GAS FIREPLACE <br /> _ FLOOR DRAIN GAS RANGE � <br /> _ BACKFLOIN PREVENTER GAS FIPING � <br /> _ SINK(SERVICE/BAR/A10PiETC.) EXHAUST FAN <br /> _ OTHER OTHER � <br /> I <br /> I HEREBI'CERITIFY THAT I HAVE READ AND EX;1A11NED THIS APPLICATION AND KNOW 7HE SAME TO BE TFUE AND CORFECT. ALL I <br /> FROVIS104S OF LAWS AND ORIDINACc'S GOVERNING THIS NPE OF l�'JRK WILL 8E COMPLIED 1NITH 1NHETHER SPECIFIED HEREIN OR ' <br /> NOT. TNE GRANTING OF A PERMIT DOES NOT PRESUA7E TO GIVE AUTHORITY TO VIOLITE OR CANCEL THE PROVISION OF ANY OTHER �� <br /> STATE OR LOCAL L'+lN REGUL4TING CONSTRUCTION OR THe PERFOFh7ANCE OF CONSTRUCTION. THAT I AA7 AUTHORIZED BY 7HE I <br /> , OIVNeR OF TNIS PROPERTY TO PERFORM 7HE WORK FOR ViHICH APPL'CATION IS MADE AND I COtdPLY\NITH THE STATE � <br /> , COfdTRACTORS LAVJ 18.27 R VVi.�¢�96.2001NAC. � <br /> l <br /> _ l� �, � � ? '�3/bS� <br /> Signature of, wneu ontractodAuthonzed Agent Date <br /> ' '/a <br /> DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />