Laserfiche WebLink
PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 — FAX 425-257-8857 > �' - <br /> 1���1 � -a_, ��� <br /> SITE ADORESS PARCEL TAX I.D.N PERMI7 n �? <br /> �.�� ,x L c. � ,� - ;;�, <br /> LEGA LOT NO. BLOCK TRACT <br /> DESC. <br /> OWNER AD�RESS ZIP PHONE <br /> 1� E �l tc�a � s��- 3�- 0�4- <br /> TENANT NAM[ CONTACT NAME PHONE <br /> CONTRACTOfl G�I n'� ADDRESS ZIP CONTR.LICENSE N <br /> PHONE <br /> i <br /> PROPOSED USE OF BUILDING Buildinn f'1 Mechanical Addilion HEAT SOURCE <br /> PERMIT COrtlbination �_� Plumbing WORK Alteretion R Electric � <br /> � Tl'PE Demolition LJ Sign TYPE New u Ges <br /> Sprinkler(k ol heads) RepaidMainL L� Other <br /> CONTRACT PRICE OF WORK CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 I <br /> WORKDESCRIPT{ON�d�V�' ��-{-�� '�-� L� UI/�I(� vy� GE . ADp � �o�214toZS <br /> � 6 A-t��b`'� -+o Ot-�'n c � � <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FII(TURE OR ITEM NO. TYPE OF PIXTURE OR�TEh1 <br /> v WATER CLOSET(TOILET) A/C—A/HANDLING UNITS <br /> BATHTUB FORCED AIR SYSTEMS <br /> � LAVATORY (WASH BASIN) HEAT PUMP <br /> ✓ SHOWER � UNIT HEATERS ; <br /> _ KITCHEN SINK& DiSPOSAL CLOTHES DRYER I <br /> DISHWASHER RANGE HOOD <br /> LAUNDRY TRAY WATER HEATER <br /> CLOTHES W.4SHER METAL FIREPLACE/STOVE <br /> URINAL FIREPLACE INSERT <br /> DRINKING FOUNTAIN GAS FIREPLACE <br /> FLOOR DRAIN GAS RANGE <br /> BACKFLOW PREVENTER GAS PIPING <br /> SINK(SERVICElBAR/MOP/ETC.) � EXHAUST FAN <br /> OTHER OTHER <br /> I H[REBY CERITIFY THAT I HAVE READ AND EXA��IINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br /> PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TYPE OF WORK�VILL BE COMPLIED WITH WHEfHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE Ofi CANCEL THE PROVISION OF ANY OTHEfi <br /> STATE OR LOCAL LAW REGULATING CONSTRUCTIf,1 N OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHOR2ED BY THE � <br /> OWNER OF THIS PROPERTY TO PERFORM17 THE 01iK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 78.27 RCW AND 296.200 W C <br /> � � � �� a6 <br /> ;����� ,�- <br /> Signature ol OwnedCoNractodAuthoriz ent Date <br /> 1�2 <br />