Laserfiche WebLink
P�RMIT APPLiCATIOIv <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.# PER611T# <br /> ��'ti�,,� _ ���- �- /Y�oy c��-039 <br /> LEGA LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRESS ZIP PHONE <br /> i(/A.0 f3Ac'N //C Z /.�2 L��6///A.r10 .4�� 9<9�6/ �/zs- zs2- 75�r0 <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> CONTRACTOR ADDRESS ZIP CONTR.LICENSE# <br /> L/�ilAGiry /�I�Al/.tJ6 �!G-+7 �/Gi 4N �'� Gr!/, ` �;l <br /> PHONE �I3� 'i� 9U.4l-/ff��.Yi�f� <br /> PROPOSED USE OF BUILDING r Building fA�MeChanical Addilion HEAT SOURCE <br /> PERMIT � Combinalion F_� Plumbing WORK �Alleralion �ElecMc <br /> TYPE Demolition LJ Sign TYPE New � Gas <br /> .rip�inklB� Repair/MainL Olher <br /> CONTRACT PRICE OF WORK CITY OF EYERETT LOCO.L SALES TAX CODE IS 310Ci <br /> WORK DESCRIPTION <br /> /NSl�!/� G4J' r'di'.,t,.eCf=.r� fi6✓'l� a,�o C.�r �/�'l <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> WATER CLOSET(TOILET) A/C—A/HANDLING UNITS <br /> BATHTUB ,i_ FORCED AIR SYSTEMS <br /> LAVATORY(WASH BASIN) HEAT PUMP <br /> SHOW ER UNIT HEATERS <br /> KITCHEN SINI<&DISPOSAL CLOTHES DRYER <br /> DISHWASHER RANGE HOOD <br /> LAUNDRY TRA'f Z WATER HEATER <br /> CLOTHES WASHER METAL FIREPLACE/STOVE <br /> URINAL FIREPLACE INSERT <br /> � DRINKING FOUNTAIN GAS FIREPLACE <br /> I FLOOR DRAIN GAS RANGE <br /> BACKFLOW PREVENTER L5" GAS PIPING <br /> SINK(SERVICE/BAR/MOP/ETC.) EXHAUST FAN <br /> ' OTHER OTHER <br /> I — — <br /> I <br /> , I HEREBY CERITIFY THAT I HAVE READ AND EXAM1IINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL I <br /> PROVISIONS OF LAWS AND ORIDINACES GO\'eRNING THIS TYPE OF WORK WILL 9E COMPUED WITH WHETHER SPECIFIED HEREIN OR <br /> 1 � NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOL4TE OR CANCEL THE PROVISION OF ANY OTHEPo <br /> ��i STATE OR LOCAL LAW REGUTATING CONSTRUCTION OR TNE PERFOR6IANCE OF CONSTRUCTIGN. THAT I AM AUTHORIZED BY THE <br /> I OWNER OF THIS PROPERTY TO PERFORhi THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY INITH THE STATE <br /> � CONTRACTORS LAW 18.27 RC AND 290".:00 WAC. <br /> j ��� :�r� /� -a�-�' � � <br /> Sgnature o Owner/ ontractodAuthorized Agent Date � <br /> ' DEBIT& CREDIT CARDS ARE NOT ACCEPTED <br /> � <br />