Laserfiche WebLink
ERMIT APPLICAT. JN <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257.8810 -- FAX 425-257-8857 <br />SITE ADDRESS PARCEL TAX I.D, k PERMIT a <br />5 Z1 AL't_ <br />(ill/—OUS <br />LEGA LOT NO. BLOCK TRACT <br />DESC. <br />OWNER ADDRESS ZIP PHONE <br />TENANT NAME I <br />CONTACT NAME PHONE <br />CONTRACTOR �'�" UJ J ✓n C. ADDRESS 7 ZIP CONTR. LICENSE M <br />L�HI�(Nu•�C ru0-37 <br />PHONE <br />�/T I�Y�C�S,cC50S <br />PROPOSED USE OF BUILDING <br />PERMIT <br />Building Mechanical <br />Combination �R( Plumbing <br />WORK <br />Addition <br />{R_[ Alteration <br />HEAT SOURCE <br />Electric <br />TYPE <br />Demolition Lj Sign <br />TYPE <br />�j New <br />Gas <br />Gas <br />P <br />Sprinkler <br />Lj Repair.?,7aint. <br />Other <br />CONTRACT PRICE OF WORK VO <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />WORK DESCRIPTION <br />1 <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />NO. I TYPE OF FIXTURE OR ITEM <br />WATER CLOSET <br />_ <br />A/C — A/HANDLING UN11-S <br />_ <br />BATHTUB <br />_ <br />FORCED AIR SYSTEMS <br />_ <br />LAVATORY (WASH BASIN) <br />HEAT PUMP <br />_ <br />SHOWER <br />UNIT HEATERS <br />KITCHEN SINK & DISPOSAL <br />CLOTHES DRYER <br />DISHWASHER <br />__ <br />RANGE HOOD <br />LAUNDRY TRAY <br />WATER HEATER <br />CLOTHES WASHER <br />METAL FIREPLACE/STOVE <br />URINAL <br />FIREPLACE INSERT <br />= <br />DRINKING FOUNTAIN <br />GAS FIREPLACE <br />_ <br />FLOOR DRAIN <br />GAS RANGE <br />BACKFLOW PREVENTER <br />GAS PIPING <br />SINK (SERVICEiBAR/MOP!ETC.) <br />EXHAUST FAN <br />i <br />OTHER <br />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 ORID.NACES 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 <br />ANY OTHER <br />STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION, THAT I AM AUTHORIZED BY THE <br />OWNER OF IIHIS PROP ER ORM THE WORK FOR WHICH APPLICATIGN IS MADE AND I COMPLY WITH THE STATE <br />CONTRACT FS V 18.27 ' AND 96.200 WAC. <br />// Z <br />Si e I Owner n ractor/Authorized Agent ate %� it �enj <br />