Laserfiche WebLink
f _. <br />P r2M11' APPLlCATIC�nI <br />CITY OF EVERETT PERMIT SERVIC�S <br />''""; 3200 CEDAR STREET, EVERETf, WA 98201 <br />425-257-8810 - FAX 425-257-8857 <br />SITE ADGReSS <br />�-�.-r� S. <br />SEGAL LOTNO. <br />TENANTNAME <br />_ � <br />CONTRACTOR �`��`� K <br />� �� <br />BLOCK <br />PHONE 2O(p� '7 �'7 � SU �Q <br />J <br />PROPOSED USE OF BUILDING <br />R�sra� r�,�, r <br />CONTRACT PRICE OF WORK <br />WOfiK OESGRIPTION <br />P16� , <br />PARCEL TAX I.D. # <br />CONTACT FOR PERMIT <br />LHrry ��bo%�sa,�.o <br />PERMIT # <br />PHONE <br />Zo�-3�,7-Sd/o <br />ADDRESS ZIP CONTR. LICENSE # <br />p. �, x��� t �,fg E�fw�,da <br />y�yp . 9 8a � o �OMEK I-� ; 7,%/� <br />Building Mechanicai <br />PERMIT B Combination � Plumbing <br />TYPE D Demolilion Sign <br />U Sprinkler <br />NO. � TYPE OF FIXTURE OR ITEM <br />WATER CLOSET (TOILET) <br />BATHTUB <br />Lr1VATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK & DISPOSAL <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTER <br />SINK (SERVICE/BAR/MOP/ETC.) <br />OTHER <br />/Nd � v� o �t � vr+i,u5 <br />Addilion I HEATSOURCE <br />Alteration [� ElecMc <br />New �l Gas <br />Repair/Maint. U Olh=r <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />N0. . � TYPE OF FIXTURE OR ITEM <br />A/G-A/HANDLING UNITS <br />FORCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT HEATERS <br />CLOTHES DRYER <br />R,4NGE HOOD <br />WATER HEATER <br />METAL FIREPLACE/STOVF <br />FIREPLACE INSERT <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUSTFAN <br />OTHER <br />�. <br />I HEREBY CERITIFY THAT I HAVE READ AN� EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LqWS AND ORIDINACES 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 ANY OTHER <br />STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />COfjl.TRACTORS LAW 18.27 RCW AND 29fi.200 WAC. <br />Cl�i.�c-�o_..�� ��u .� S�/� �a �f <br />DEBIT &`CREDIT CARDS AREeNOT ACCEPTED � <br />