Laserfiche WebLink
SITE ADDRESS <br />d��G �.s <br />LEGAL LOT NO. <br />DESC. <br />OWNER <br />�J�QCI� �fY <br />RMIT APPLICATIUN <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 � <br />425-257-8810 - FAX 425-257-8857 SL �� O.3 -Uz�/ <br />PARCEL TAX I.D. # <br />dFs���aU _ cul- 008- c� <br />BLOCK I TRA.CT �r�0'�dy'�,pl-OIlO"C� <br />�3Hlo"�ialxl (-1V(� W , cir rnorv <br />(ilUL�l�nn Lllf� a$o'1%5' (ya5) <br />TENANT NAME '' � � CONTACT FOR PERMIT �� PHONE <br />�C��o«��ane'.e. Y�ic� I Viris �,rtin3l-�cm,i ��1�5)a3&- ID9�/ <br />CONTRACTOR ADDRESS ZIP CONTR. LICENSE # <br />PHONE -��C-�qiG�L� <br />PROPOSED USE OF BUILDING <br />11��c� Dec�le�s1„� <br />CONTRACT PRICE OF WORK <br />WORK DESCRIPTION <br />NQ.IU �iZ�C� f S1l\ �J <br />NO. I TYPE OF FIXTURE OR ITEM <br />WATER CLOSGT (TOILET) <br />BATHTUB <br />LAVATORY fWASH BASIN) <br />SHOWER <br />KITCHEN SINK 8, DISPOSAL <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOP. DRAIN <br />BACKF LOW PREVENTER <br />SINK (:iERVICE/BAR/MOP/ETC.) <br />OTHER__ <br />Building Mechanical Addition <br />PERMIT � Combinalion R Plumbing WORK R Alteration <br />7YPE Demolition � Sign TYPE R New <br />Sprinkler U Repair/Maint. <br />HEATSOURCE <br />Electric <br />Gas <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />NO. _ � TYPE OF FIXTURc OR ITEM <br />A/C-A/i�ANC'..ING UNITS <br />FORCED AIP SYSTEMS <br />HEAT PUMF' <br />UNIT HEATERS <br />CLOTHES DRYER <br />RANGE HOOD <br />WATER HEATER <br />METAL FIREPLACE/STOVE <br />FIREPLACE �NSERT <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUSTFAN <br />OTHER <br />I HEREBY CERITIFY THAT I HAVt READ AND E;WMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE A�'� 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 PERFORPdANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATIOtJ IS MADE AND I COMPLY WITH TF'E STATE <br />CONTRA6'FORS LAW 18.27 RCW AND 296.200 WAC. <br />�t1��.1� i�r� L�C� �I n �J3�D3 <br />��L <br />DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />