Laserfiche WebLink
, , <br /> P�RMIT APPLICATI N <br /> CITY OF EVERETT PERMIT SEFcVICES <br /> 3200 CED,4R STREET, EVEFtETT, WA 98201 <br /> 425-257-8810- FAX 425-?57-8857 <br /> SITE ADDRESS PARCEL TAX I.D.# P RMIT <br /> �`i I 5 Lo��� 00(_�� 68.�8 c�o I (��b�/ -oa� <br /> LEGA LOTNO. BLOCK TRACT <br /> DESC. g �g7 <br /> OWNER ADDRESS 21P PHONE <br /> '�l+�'-Y �AR�-1"S l0(�O NL- loot� �—/�A711,E `IBILS 2�6-5�-(�I <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> ` ,.. 1�'1��.� I��-�a-F►-i�A 2a6� �8� I6 I¢ <br /> CONTRACTOR ADDRESS ZIP CONTR.LICENSE N <br /> PHONE <br /> PROPOSED USE OF BUILDING Building D MechaniCal Addition HEAT SOURCE <br /> MA�T� ��F'- QV�21Yo5 PERMIT Combination U Plumbing 1YORK Alleration Electric <br /> TYPE � Demolilion U Sign TYPE � New � Gas <br /> �.�SFMt�N'I - Ot t-icf5 l Sprinkler U RepaidMalnt U Other <br /> CONTRACT PRICE OF WORK �2/�� ^'o CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 i <br /> WORK DESCRIPTION <br /> f��D Neu> {-.�iT i�Tr�� R fao,u 136�s�t.uCNT 7o Go�BY AI.�E. <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF PIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> WATER CLOSET(TOILET) A/C—A/HANDLING UNITS <br /> BATHTUB FORCED AIR SYSTEMS <br /> LAVATORY(WASH BASIN) HEAT PUMP <br /> SHOWER UNIT HEATERS <br /> KITCHEN SINK&DISPOSAL CLOTHCS DRYER <br /> DISHWASHER RANGE HOOD <br /> LAUNDRY TRAY WATER HEATER <br /> CLOTHES WASHER METAL FIREPLACE/STOVE <br /> URINAL FIREPLACE INSERT <br /> DRINKING FOUNTAIN GAS FIREPLACE <br /> FLOOR ORAIN GAS RANGE <br /> BACKFLOW PREVENTER GAS PIPING <br /> SINK(SERVICE/BAR/MOP/ETC.) EXHAUST FAN <br /> OTHER OTHER <br /> I HERE6Y CERITIFY THAT I HAVE READ AND EXP.MIN[D THIS APPLICi.TION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br /> PROVISIONS OF LAWS AND ORIDINACES GOVERNING TNIS TYPE OF 6VORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANC�L TFiE PROVISION OF ANY OTHER <br /> STATE OR LOCAL LAW REGULATING CONSTRUCTION OR TFiE 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 /> CONTRACTORS LAW 78.27 RCW AND 296200 WAC. <br />'. Signature uf OwnedContractor/Authonzed Agent Date �a <br /> DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />