Laserfiche WebLink
;-�� P�;..RMIT APPLICATII,N <br /> CITY OF EVERETT PERMIT SERVICES <br /> .._ 3200 CEDAR STREET, EVERETT, WA 98201 , 425-257-8810 <br /> c�:i�i; <br /> SITE ADDRESS PARCEL TAX I.D.# PERMITi! <br /> 45'_0 DL'LA�1'ARG AVf:, I:VCRBI�I', \VA 98303 00407R01804300 <br /> 1�'1 D5o (—�(D <br /> LEGAL LOT NO. BLOCK ITRACT <br /> DES . <br /> UWNER ADDR[�� PHONE <br /> sriiiNcr_a. t�o� �s2c ur_i.nwniit:nvr �.�zs�as�-��zi <br /> • evr:iir i���. �vn �s?os <br /> TENANTNAME CONTACTNAME PHONE <br /> i>nn�r:i.n mi.� .��s si�-�iz•i .i;s <br /> CONTRACTOR ADDRESS CONTR.LICENSE# <br /> P:1S'? \VA'I'GR {iGATf_R CO�1PANl' 12601 132ND AVIi Nf_ FAS"I'WI ICO>?DP <br /> ���_�5�� 31�� hIRKLAND. IVA 9li034 0_'IG/2005 <br /> PROPOSED USE OF BUILDING eui�dinp MeehaNea nddition HEAT SOURCE <br /> PERMIT Combinetfon Plumbing WORK , q7teretion []Electric <br /> TypE Damolilion Slgn TYPE New as <br /> S rM r Ra airlMalnt ther <br /> CONTRACT PRICE OF WORK S349.00 CITY OF EVERETT LOCAL SALES TAX CODEIS 3105 <br /> WORK DESCRIPTION ������ovdReplacc f Iectric Nater licater <br /> P�UMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> _______ WATER CLOSET _______ AIC•AIHANDLING UNITS <br /> _______ BATHTUB ______ FORCED AIR SYSTEMS <br /> _______ LAVATORY (WASH BASIN) _____ HEAT PUM'P <br /> ____ SHOWER ___ UNIT HE,�;f�RS <br /> ______ KITCHEN SINK $ DISPOSAL _____ CLOTHES DRYER <br /> ____ DISHWASHER ___ _ RANGE HOOD <br /> ____ LAUNDRY TRAY ___�__ WATER HEATER <br /> ____ CLOTHES WASHER ____ METAL FIREPLACE/STOVE <br /> _�_ URINAI. ____ FIREPLACE INSERT <br /> _�_ DRINKING FOUNTAIN _,_ GAS FIREPLACE <br /> ____ FLOOR DRAIN ��_ GAS RANGE <br /> ______ BACKFLOW PREVENTER _, GAS PIPING <br /> _____ SINK (SERVICElBAR1MOPfETC.) _�_ EXHAUST FAN <br /> ----- OTHER_ ���_ OTHER------------------------ <br /> ----- ---- ---------- ------- ----------------------------- <br /> ----- � -------------- — ---- -------------------- <br /> 1 HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS APLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> PROVWiONS OF LAWS AND ORDINANCES GOVERNW(�� iIS TYPE OF WORK WILL BE COMPLIEO WIHT WNETHER SPEGFIED MEREI <br /> OR NOL THE GRANTING OF A PERMIT DOES NOT PRE: ..IE TO GIVE AUTHOR�TY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER 57ATE OR LOCAL lAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHOR�ZED <br /> BY THE OWNER OF THIS PROPER?Y TO PERFORM THE WORK fOR WHICHAPPLICATION IS MAOE AND I COMPLY WITH TFIE STATE <br /> CONTRACTORS LAW 18.27 RCNi AND 236.200 WAC. <br /> Signalure of OwnedContractorlAuthorized Ageni , � Date 01/OG'2005 <br /> u�om <br />