Laserfiche WebLink
SITE ADDRESS <br />U�15� �Y. <br />LEGAL LOT NQ. <br />� �1 uJ'1 I�7/ <br />TENANTNAME <br />�t � <br />CONTRACTOR <br />PHONE <br />�RIVIIT APPLICATI �N <br />CITY AF EVERETT PERMlT SER`�/ICES <br />3200 CELAR STREET, EVERETT, WA 98201 <br />425-257-881 G — FAX 425-257-8857 <br />�Kao� 2 <br />TRACT <br />AD�RE <br />33,� � <br />PROPOS[0 USE OF BUILDING <br />Qf1YL i-"ru 2��?rti5�.�1 $�hyn.� PERMIT <br />TYPE <br />CONTRACT PRICE QF WORK <br />�ARC L� TAX I.D. tF <br />°�Y� O°� °v� °. <br />CONTACT FOR PERMIT <br />sj���Y, ����1 <br />AI7DRC S5 <br />O���e L,;��.� 5y,r�ns <br />PHONE <br />fl��ildinc� Mechanical <br />C.imbination Plumbing <br />Cemolition Sign <br />uarinkler <br />WORK DESCRIPTION /Y7UV�' Nk�S�-'��� �I�NICIIn� <br />sinl� I.v<��eY nn� c�ra�n: <br />NO. I TYPE OF FIXTURE OR ITEM <br />WATER CLOSET (TOILET) <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK S DISPOSAL <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKIt�G FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTER <br />SINK (SERVICE/BARlMOP/ETC.) <br />OTHER <br />ZIP CONTR. LICENSE # <br />Addition I HEAT SOURCE <br />AlteraGon ElecVic <br />i:�:a Gas <br />F e; a7/Maint. Other <br />CITY OF EVERETT LOCAL SALES �iAX CODE IS 3'105 <br />/ec�.+��� nnc� �(k,n(� ��r <br />NO.. � TfPE OF FIXTURE OR I7EM <br />A/C — A/HANDLI NG ' INITS <br />FURCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT HEAT�RS <br />CLOTHES URYER <br />RANGE HOUD <br />WATER HEATER <br />METAL FIREPLACE/STOVE <br />FIREPLACE INSERT <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUSTFAN <br />OTHER__ <br />I HERE3Y CERITIFY THAT I HAVE READ AND EXAA�INED THIS APPLICATION AND KNOW THE SAME TO �E TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS'fYPE OF WORK WILL BE COMPLIED INITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRAqqqN���T...ING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PR'JVISION OF ANY OTHER <br />STATE O� �� W R�UL[�TING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER O TH RGPER � PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTr3A TO W 182 R AND 29620C WAC. <br />DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />