Laserfiche WebLink
( �`. <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT ��ERVICES <br /> 3200 CEDAR STREET, EVERETf, WA 38201 <br /> 425-257-8810—FAX 425-257-8857 <br /> SITE ADDRE55 PARCEL TAX I.D.# P Ra��T� <br /> oA�DG� 54e Do�k3 �Co 7 62- av � p0 aYr�6.o�8' <br /> LEGAL LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER ADORESS LP PHONE <br /> TENANTNAME CONTACTFORPERMIT PHONE <br /> �i�Wa�D Jo�es � ka-�-i-t� h�o�.k�� ( -�, St7-6 �u� <br /> CONTRACTOR ADDRESS ZIP CONTR.LICENSe r <br /> m At2kP�1- Co�.�S r �"t� t o35a rl C . rn"�-�� <br /> PHONE ��'�� ( O� �7�'� �(YIrt�kEla�� <br /> PROPOSEUUSEOFBl11LUING Building DMechaniral I n _Addition I HEATSQURCE <br /> ryfplleration �S Eledric <br /> PERMI7 Combinalion U Plumbing WORK K <br /> �" 7YPE Demolition U Sign TYPE �{ New �..� Gas <br /> n. I ..�, � ( r'„��p� IML.r.� Sprinkler U RepairlMainl. U Olher <br /> Fc.u��r �Z ' 't <br /> CONTRACT PRICE OF WORK �33 p p o CITY OF EVERETT LOCAL SALES TAX CODE IS 5105 <br /> WORK DESCRIPTION <br /> Lo.M M c�-�-1 � . <br /> PLUM8ING MECHANICAL <br /> N0. TYPE OF FIXTURE OR ITEM N0. TYPE OF FIXTURE OR ITEM <br /> WATERCLOSET _, AIC—A/HANDLINGUNITS <br /> BATHTUB _ FORCED AIR SYSTEMS <br /> LAV.��TORY(WASH BASIN) _, HEAT PUMP <br /> SHOWER _ UNIT HEATERS <br /> KITCHEN SINK 8 DISPOSAL _ CLOTHES DRYER <br /> DISHWASHER _ �NGE HOUD <br /> IAUNDRY TRAY _, WATER HEATER <br /> CLOTHES WASHER _ METAL FIREPLACEISTOVE <br /> URINAL _ FIREPLACEINSERT <br /> DR�NKING FOUNTAIN _ GAS FIREPLACE <br /> FLOOR DRAIN _ GAS RANGE <br /> BACKFLOW PREVENTER _ GAS PIPING <br /> SINK(SERVICE/BAR/MOPIETC.) _ �HAUST FAN <br /> OTHER _ OTHER <br /> I HEREBY CERITIFY THAT I HAVE READ/1ND 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 NMETHER 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 /> CONTRACT RS LAW 18.27 RCW AND 296.200 WAC. <br /> -�(�f./ /}�/ v � �b/��I <br /> Signatur of Own� ontractor A t�zed Agent �Da� <br /> DEBIT& CREDIT CARDS ARE NOT ACCEPTED <br /> `/z <br /> , <br />