Laserfiche WebLink
PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES G `� 6�� <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810— FAX 425-257-8857 <br /> P�,� y�c� — � <br /> SITE AUDRESS PARCEL TAX I.D. # PE ��nT tt <br /> J "� �—C�l — ci5 —ca �� � <br /> �' <br /> LEGAL LOTNO. BLOCK TRACT <br /> DESC. � I�lNr 1 V, /� _ <br /> OWNER ADDRE55 ZIP PHONE <br /> �7 ' � <br /> TENANTNAME I CONTACTFORPERMIT PHONE <br /> 7E� 1� �� - �i ' O <br /> CONTRACTOR ADDRESS 21P CONTR.LICENSE# <br /> f-�-��l� f nuc f-► /-l�n�r� i.,c,c. 4'�a5 3��, Avz sE 95us (liG,%�ITf-ILS77OM <br /> PHONE (I�r/ <br /> �ll t; <br /> PROPOSED USE OP BUILDING Building t�Mechanical Addition HE47 SOURCE <br /> PERMIT Combinalion ��Plumbing WORK Atleration Electric <br />� TYPE �Demoli�ion LJ Sign TYPE New � Gas <br /> SNrinkler RepairrMaint ' Otner <br /> CONTRACT PRICE OF WORK � � g p� p�-p � CITY OF EVERETT LOCAL SALES TAX CODE IS 7105 <br /> 1h'ORK OESCRIP7'ION (3 i;�L p �1�W j7 U�j>Lk!)C <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> � WATER CLOSET(TOILET) //' ` Z PJC-A/HANDLING UNITS <br /> � BATHTUB �� ,� FORCED AIR SYSTEMS <br /> LAVATORY(WASH BASIN) �!7 _ HEAT PUIv1P <br /> � SHO�VER � _ UNIT HEATERS <br /> � KITCHEN SINK 8 DISPOSAL � CLOTHES DRYER <br /> � DISHWASHER � RANGE HOOD <br /> .g'� LAUNDRY TRAY � WAT[R HEATER <br /> � CLOTHES WASHER � METAL FIREPLACE/STOVE <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.) g� EXHAUST FAN �� ��� <br /> b OTHER OTHER <br /> — I --- <br /> I HEREBY CERITIFY THAT I HAVE READ AND E,�AMINED THIS APPLICATION AND KNOW THE SAME TO OE TRUE AIJD CORRECT. ALL <br /> PROVISIONS OF LA�VS AND ORIDINACES GOVERNING THIS TYPE OF N'ORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOWTE OR CANCEL THE PROVISION OF ANY OTHER <br /> STATE OR LOCAL LAW RC-GULATING CONSTRUCTION OR THE PERFORh7ANCE OF CONSTRUCTION. T4AT I AA4 AUTHORIZED BY THE <br /> OVJNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS tdADE AND I COMPLY WITH THE STATE <br /> CTORS LAW 1827 RCW AND 296.200 N'AC. <br /> � --�-- . - � ' Lp.��_ .� <br /> Si;nature o Own r/ ontractor/Authonzed Agent Date w G�S�S <br /> DEBIT 1� CREDIT CARDS ARE NOT ACCEPTED 5 y(2- <br />