Laserfiche WebLink
SITE ADDRESS <br />LOT NO. <br />'PERMIT APPLICA'fION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 <br />BLOCK i TRACT <br />PARCEL TAX I.D. # <br />�U7 OC��Ob <br />PERMIT � /_ <br />\� ���i"�%Yl <br />Q'ti1ii� ��E �l ��T QD 8�7✓�o►-�S `��020 <br />TENANTNAME CONTACTFORPERMIT PHONE <br />�� c�,� _ a�.�. t-t��. �� . ��s� «3 <br />CONTRACTOR f�p��� � <br />� Gq�c-�.Gi <br />PHONE L�'�5 .�O • b� <br />PROPOSED USE OF BUILDING <br />CONTRACT PRICE OF WORK <br />ADDRESS lnd...,� , yo , , � �. 21P <br />.-,.T T.��� <br />Gap� a�,.s �.tw <br />7lS•12.i� ��" <br />j� Building <br />PERMIT j� Combination <br />TYPE D Demalition <br />U Sprinkler <br />CONTR. LICENSE # <br />�� ~ 989J � <br />Me hanical Additlon HEATSOURCE <br />Pli ing WORK AlteraLon Electric <br />Sign TYPE New � Gas <br />RepaiUM.�int. L� Other <br />CITY OF EVERETT LOCAL SALES TAX CGDE IS 3105 <br />WORK DESCRIPTION i � <br />�I��JTa9'h- �LO i� 4 Wi�'�At- `�l�jl.� ����it��'�16w� �l?.7t7�'I,y 'j"C1 <br />T-��� �arb w�et.,- � �sna� P,w6 ��l�s�� <br />NO. I TYPE OF FIXTURE OR ITEM <br />WATE CLOSET (TOILET) <br />BATHT <br />LAVATOR (WASH BASIN) <br />SHOWER <br />KITCHEN SIN DISPOSAL <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FlOOR DRAIN <br />BACKFI.OW PREVENTER <br />SINK (SERVICE/BAR/MOP/E <br />OTHER <br />NO., I TYPE OF FIXTURE OR ITEM <br />A/C — A/HANDLING UNITS <br />FORCED AIR SYSTEMS <br />HEAT PUMP <br />l�NIT HEATERS <br />CL�pTHES DRYER <br />RArTGE HOOD <br />M ETAL <br />GAS FIREPLAl <br />GAS RANGE <br />GAS PIPING <br />EXHAUST FAN <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 G OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANC'cL THE PROVISION OF ANY OTHER <br />STATE OR OCAL � REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER O THIS PRdPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE ANO I COMPLY WITH THE STATE <br />CONTRA ORS LAW 18.27 RCW AND 296.200 WAC. <br />DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />