Laserfiche WebLink
�ERMIT APPLICATI�N <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-6810- FAX 425-257-8857 <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT#_ <br /> ' 0 ��}5TC^o%',c/ ✓�� M o3�S- �a�J <br /> LEGA LOT NO. BLOCK TRACT <br /> DESC. <br /> OWNER .4DDRESS ZIP PHONE <br /> /1/�,t/�� �� Uts��c/ �9a� �gst �/eu D� q�da3 y�5-.�33 � 3��/ <br /> TENAN�AME CONTACTFORPERMIT PHONE <br /> CONTRACTOR -/- , /� AUDRESS ZIP CONTR.LICENSE# <br /> PHONE�?I�E �r_II�S/�L�-L�7�/O� <br /> PROPOSED USE OF BUILDING Buitding � Mechanical Addition HEAT SOURCE <br /> 5 � � PERMIT B Combination Plumbing WORK R ?Jteration � ElecUic <br /> TYPE D Dei.iolilion Sign TYPE D New Gas <br /> U Sprinkler � RepairlMaint. Other <br /> CONTRACT PRICE OF WORK 3 q yq CITY OF EVERETT LOCAL SALES TAX CODE IS 9105 <br /> WORK DESCRIPTION �� y O� (jl�� � <br /> Q�,(�,;GeGn�+ �!'i,d �/�� l� �•�6 <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO.. TYPE OF FIXTURE OR ITEM <br /> WATER CLOSET(TO�LET) A1C-A/HANDLING UNITS <br /> BATHTUB FORCED AIR SYSTEMS <br /> LAVATORY(WASH BASIN) _ HEAT PUMP <br /> SHOW ER UNIT HEATERS <br /> KITCHEN SINK& DISPOSAL CLOTHES DRYER <br /> DISHWASHER RANGE HOOD <br /> LAUNDRY TRAY � X WATER HEATER <br /> CLOTHES WASHER METAL FIREPLACEISTOVE <br /> URINAL �_ FIREPLACE INSERT <br /> DRINKING FOUNTAIN GAS FIREPLACE <br /> FLOOF DRAIN GAS RANGE <br /> BAChFLOW PREVENTER � GAS PIPING <br /> SINK(S�RVICE/BARIMOP/ETC.) _ EXHAUST FAN <br /> OTHER OTHER <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 AUTHqRITY 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 LA�W)827 RCW AND 296.200 WAC. <br /> �����,� �.�.�.�a�, 9�a/o3 <br /> Si ature wnc+dContractodAuthonzedAgent � 'Date <br /> DEBIT& CREDIT CARDS ARE NOT ACCEPTED <br />