Laserfiche WebLink
--�.> — <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810- FAX 425-257-8857 <br /> SITE ADDRESS �`o�, I pARCEL TAX I.D.# PERMIT# <br /> o!o s� c���o� F-h �.��� �,.� Z BoSI � oa 30 660o I �Q�-rJl� <br /> LEGAL LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER ADORESS <br /> ZI� PHONE <br /> �V�� -rF /y�MII aa"1-i[� I�. � S6t II � � �V<.GT Lt�(- <br /> TENANT NAME I CONTACT FOR PERMIT PHONE <br /> (.✓�l� S t� rqo S�Gut �Lo�y �i �fls"- 7)6- ��35"" <br /> CONTRACTOR � ADDRESS <br /> ��rry Ncc.v Co ZIP CONTR.LICENSE# <br /> PHONE 7�oc� /��r-�iso.c� %'�J de.��y.�coJ7c� <br /> I �{zs- 7�6-SS�s- rc� :..�{./� �,.4 �i8z�. 3 r <br /> � PROPOSE�USE OF BUILDING Building Mechanical Addihon HEAT SOURCE <br /> I PERMIT � Comoinalion B Plumhing WORK R�-( �Alteretion Eectric <br /> (Z���✓k- 7YPE Demolition �J'Sign l'YpE -{��ew �R.( Gas <br /> Sprinklar LJ Repair/Maint. LJ Other <br /> I CONTRACT PRICE OF WORK � 70 p, Q°' CITY OF EVERETT LOC4L SALES TAX CODE IS 3105 <br /> WORKDE9^.'�`iION /.,v5F4LC C/� S'/ <br /> 3 a/ c.f 5.�,va�f o uL f 5 c.,/0.4:..�. e..Pyti, <br /> (.v(./-.� s' �r o N <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 F(JRCEU AIR SYSTEMS <br /> _ LAVATORY(WASH BASIN) HEAT PUMP <br /> _ SHOWER UNITHEATERS <br /> _ KITCHEN SINK& DISPOSAL CLOTHES DRYER <br /> _ DISHWASHER RANGE HGOD <br /> _ LAUNDRY i'RAY WATER HEATER <br /> _ CLOTHES WASHER METAL FIREPLACE/STOVE <br /> _ URINAL FIREPLACE INSERT <br /> I = 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 — <br /> � <br /> I HEREBY CERITIFY THAT I Ha�.'=ccqD AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br /> PROVISIONS OF LAW�AND OFiD1114CE5 GOVERNING THIS TYPE CF WOkK 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 ANY OTHER <br /> I� STATE OR LOCAL L4W REGULA fhVG(ONSTRUCTION OR THE PERFOR�"ANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS�ROPERTY TO PERFORM THE WORK FOR WHICH APF�ICATION IS MA�E AND I COMPLY WITH THE STATE <br /> CONTRACTORF �AW 18.2 CW� .2p -" <br /> Signature of 0� iContiactor/Authon�nt � Date <br /> IZ <br /> DEBIT & CREDIT CARDS RRE NOT ACCEFTED I <br />