Laserfiche WebLink
SITE ADURESS <br />�'o a �i <br />LEGA LOT NO. <br />DESC. <br />owNeR <br />\ t��/C� LCt <br />TENANTNAME <br />S�bs <br />CONTRACTOR <br />� <br />�ERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 <br />Sv,T� f"_ <br />PARCEL TAX I.D. # <br />BLOCK TRACT <br />ADORESS �0. Q <br />J25r�12� �9%�d ���r <br />I CONTACT FOR PERMIT <br />2p� . 1 �0� ADDRESS <br />�� M <br />PHONE a ���1 �/ � � �v�" � <br />PROPOSED USE OF BUILDING <br />CONTRACT PRICE OF WORK <br />ver.�s ��rq <br />�03�� -(� I <br />PERMITJF Y an� <br />Sc�3rc� <br />J/t nw I(� 9 �t.� —�.r,—t,�.ac-� <br />PMONE <br />u2s�ea� �1:ts-�s'�3 �d3�f <br />ZIP CONTR. LICENSE # <br />6F_R��/Nc o11 G c�r� <br />�tr Ravnrc.ogs�3 <br />Building Mechanical <br />PERMIT R Combination � Plumbing <br />TYPE D Demolilion Sign <br />U Sprinkler <br />WORK DESCRIPTION � , �] <br />�e�,rc,o,,�.2, � ' '?� � a ' m.cJ`�a. J <br />i/ <br />.�.,�-� a.��.e.�'oK �o;�,,cic�C.-� s'� <br />PLUMBING <br />N0. I TYPE OF FIXTURE OR ITEM <br />WATER CLOSET (TOILET) <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOW ER <br />KITCHEN SINK 8 DIS?OSAL <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASIiER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENT=R <br />SINK (SERVICE/BAR/MOP/ETC.) <br />OTHER <br />. <br />NO.. <br />Addition I HEAT SOURCE <br />Alteration R Electric <br />New �.,j Gas <br />RepairlMaint. L� Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />�8'� <br />TYPE Of FIXTURE OR ITEM <br />A!C—A/HANDLING UNITS <br />FORCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT HEATERS <br />CLOTHES DRYER <br />RANGE HOOD <br />WATER HEATER <br />METAL FIREPLACE/STOVE <br />FIREPLACE INSERT <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUST FAN <br />OTHER <br />� <br />;.'� <br />I HEREBY CERITIFY THAT I FiAVE 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 N'ORK 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 AUTHORI2ED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AIJD I COMPLY WITH THE STATE <br />C�RT�ACTORS LAW 18.?,7�RCW 9[JD 296.200 WAC. <br />\� l , o NJ �� � _ ,„ ,. (n_7.� _i�1 <br />DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />�L <br />