Laserfiche WebLink
� <br /> P�RMIT APi'LICATI(�N <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 — FAX 425-257-8857 <br /> SITE ADDRESS PARCEL TAl(I.D.p PE I7 tt <br /> � " Cli�i��f�wiC� �ve C� �C�Z S��OZyCO � - , <br /> LEGA LOT NO. BLOCK �RACT ' I <br /> DESC. , p �,—�-j <br /> OWNER � ' I <br /> ADORESS ZIp PHONE <br /> �,1�(1�'� �1'� �������1 /� ��U�Y �{2.5-�S'Z-4U7S <br /> TENANT NAME CONTACT fOR PERMIT <br /> PHONE <br /> i�(,� �IS61'1 �`-12�S�ZSG - �311 <br /> CONTRACTOR T�� i {,` g(A�'G��S ADORE33 ZIP CONTR.LICENSE# <br /> � �171� ��Ac�.e/ 1���' ,v G+ 4 � <br /> PHONE � Q Z�� PA�?I FC I�[�� �n' <br /> PROPOSED USE OF BUILDING I pERM1T R Cnmbi nation I� piumbing al WORK R Aldlereltlon HEA� E ecVlc <br /> �. (�l.������ T'PE � Demolillon [� Slgn �TVPE � New Gas ' <br /> � Sprinkler Ra pair/Malnt. I O l h e r <br /> CONTRACT PRICE OF WORK 'JJ�� I G� ' I t / _ CITY OF EVERETT LOCAL SALES TAX CODE IS�105 <br /> .. �, v <br /> WORK UESCRIPTION <br /> ���� 'l � �� � ���YG+�P <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF FIXTURE OR ITEM NO. I TYPE OF FIXiURE OR ITEM <br /> _ WATER CLOSET(TOILET) A/C—A/HANDLING UNITS <br /> _ BA1 HTUB FORCED AIR SYSTEMS <br /> _ LAVATORY(WASH BASIN) HEAT PUMP <br /> _ SHOWER UNITHEATERS <br /> _ KI7CHEN SINK 8 DISPOSAL CLOTHES DRYER <br /> _ DISHWASHER FANGE HOOD <br /> _ LAUNDRYTRAY �VATER HEATER <br /> _ CLOTHES WASHER PAETAL 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.) EXHAUST FAN <br /> _ OTHER OTHER <br /> I HEREBY CERITIFY THAT I HAVE READ AND EXAMINED THIS Ar�PLICATI0IV AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br /> PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TYPE OF WCRVc W',LL BE COMPLIED WI7H W4ETHER SPECIFIED HEREIN OR <br /> NOT. 7H[GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUT40RITY TO VIOLA'E OR CANCEL THE PROVISION OF ANV OTHER <br /> STATE OR IOCAI LAW REGULA7ING CONSTRUCTION OR THE PERFOF2MANCE OF CCNSTRUCTION. TMAT I AM AUTHOR�ZED BY THE <br /> OWNER OF?HIS PROPERTV 70 PERFORM 7HE WORK FOR N�HICH APPLICATION IS MADE AND I COMPLY WITH TNE STATE <br /> CONTRACiORS LAW 18.27 RCW Np 296.200 WAC. � <br /> �C�,%'�t ����� ���� G��2S��3 <br /> Signature of Owner/ ontractorlAuthonzed Agent Date (; � <br /> i1 '' / <br /> DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED �� <br />