Laserfiche WebLink
�r�ERMIT APPLICA'� iON <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERE7T, VUA 98201 <br />425-257-8810 — FAX 425-257-8857 <br />SITE ADDRESS <br />�C � <br />LEGA LOT N0. BLOCf <br />DESC. <br />OWNER <br />TENANTNAME <br />CONTRACTOR U/'"S' �'�� �^ � <br />// iv /1 / �w <br />PHONE ������ � )�� <br />— � <br />PROPOSED USE OF BUILDING <br />PERMIT <br />TYPE <br />CONTRACT PRICE OF WORK <br />PARCEL TAX �.D. # <br />TRACT <br />CONTACTNAME <br />�QYIt�S f �G�G <br />AODRESS }� � ��( <br />� <br />� <br />� <br />� <br />� <br />Building <br />Combination <br />Demolition <br />Sprinkler <br />WORK DESCRIPTION � <br />l�'re S���SSrDl9 <br />� <br />NO. � TYpE OF FIXTURE OR ITE�A <br />_ WATER CLOSET <br />_ BATHTUB <br />_ LAVATORY (WASH BASIN) <br />_ SHOWER <br />_ KITCHEN SINK 8 DISPOSAL <br />_ DISHWASHER <br />_ LAUNDRYTRAY <br />_ CLOTHES WASHER <br />_ URINAL <br />_ DRINKING FOUNTAIN <br />_ FLOOR DRAIN <br />_ BACKFLOW PREVENTER <br />_ SINK (SERVICE/BARlMOP/ETC.) <br />_ OTHER <br />D Mechanical <br />U Plumbing <br />D Sign <br />�C i�3b���`� <br />PERMIT # <br />ZIP PHONE <br />��G� 3�-91�.3 <br />LP CONTR. LICENSE N <br />9e/�€ <br />RAddition I HEATSOURCE <br />Altemtion � Electric <br />BNew Gas <br />fiepaidMaint. OLSer <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />t^ <br />NO. � TYPE OF FIXTURE OR ITEM <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 />FIREPLACEINSERT <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPIN� <br />EXHAUST FAN <br />OTHER <br />--�t�'-�—sa.��c�s��s�l�'% c�=� <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 AN� 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 CONSTRUCT�ON OR THE PERFORtAANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF Ty PROPERTY TO PERFORM THE WORK FOR WHICH FPPLICATIVN IS MADE AND I COMPLY WITH THE STATE <br />CONTRACT6�LAW 1827 RCW AND 286200 WAC. .[... <br />_ i� — <br />& CREDIT CARDS ARE NOT ACCEPTED <br />