Laserfiche WebLink
hz..RMIT APPLICATIL M <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVEREl i , WA 98201 <br />425-257-8810 - FAX 425-257-8857 <br />SITE ADDRESS PARCEL TAX I.D. # PERMIT s <br />�j 9 Z q PvgfG°IfQCy) W I MDZ 10 -003 <br />LOT NO. <br />DESC. <br />TENANT NAME <br />G <br />CONTRACTOR ra 45t'I r- i viG <br />PHONE Za <br />�7z- 6?f <br />ZIP PHONE <br />CONTACT NAME PHONE <br />EMI vlsein 36o0 <br />AnDIJIESS <br />/ 0 <br />C/AF/ CONTR. I.ICENSEJ <br />PROPQSED USE OF BUILDING Building echanical HEATSOURCE <br />JPERMIT CombinationfM <br />Plumbing WORKRAddition <br />Alteration I{'�� Electric <br />TYPE �j DemolitionSign (TYPENeal J�; Gas <br />u Sprinkler RepairRrtainl. ,u Other <br />CONTRACT PRICE OF WORK /7 n0 o I CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />WORK DESCRIPTION I <br />COvl� eAe eXls+s <br />-{vA G sy s+ev�- Ala v,(fw <br />OY <br />PLUMBING <br />NO. TYPE OF FIXTURE OR ITEM <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />WATER CLOSET <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 DISPOSAL <br />DISHWASHER <br />LAUNDRY TRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTER E <br />SINK (SERVICBAR MOP/ETC.) <br />OTHER <br />— <br />— <br />— <br />— <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 />— <br />— <br />— <br />— <br />— <br />— <br />— <br />— <br />— <br />— <br />— <br />— <br />I HEREBY CERITIFY THAT I HAVE 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 WORK 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 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 18.27 RCW AND 296.200 WAG. <br />-/-oz- <br />ZIP, <br />