Laserfiche WebLink
�� <br />I�.;RMIT APPLICAl'I'�. N <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 <br />SITEADDRESS ��/7i� ��— I7 <br />� o� ' E "Y �Tr �x� <br />LEGA LOT NO. BLOCK <br />OESC. <br />TRACT <br />PARCEL TAX I.D. # <br />PERMIT q <br />f3 c,zm 6-r�a <br />�¢zs— 4S3 S'�ab <br />� �v 9��0 � <br />TENANTNAME I CONTACTNAME PHONE <br />sTR�.�3,^�rGH'� ,D��'��a a- <br />�-�9�ufNG n_F.�rE,2 /�L 1�/N� (3af�Cr%7�i� <br />CONTRACTOR ADDRESS ZIP CONTR. LICENSE N <br />GA i-� �c�u c,o,� sT <br />PHONE Q Z S 3,3 6 �! l � <br />PROPOSED USE C+' BUILDING <br />D�y �,�eE � '•7�iQlV/N( PERMIT <br />TYPE <br />CONTRACT PRICE OF WORK <br />WORK �ESCRIPTION <br />R�m6., � Id� <br />d s rNKs, �-has <br />Bui!ding Mechanlcal <br />Comtination � Plumbing <br />Demolition Sign <br />Sprinkler <br />,Q Addition I HEATSOURCE <br />,p(y Alleration � Electric <br />gNew Gas <br />fiep2idMaint. Other <br />CITY OF EVERETT LOCAL SALES TAX COOE IS 3105 <br />(W�'i,c-� /��D l5B Wdtc."f' �AO �'rb�zr�Ts �-6.gYI�%.li,F' <br />NO. � TYPE OF FIXTURE OR ITEM <br />WATER CLOSET <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 DISPOSAL <br />DISHWASHER <br />LAUNDRY TRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTEF <br />SINK (SERVICE/BAR/MOP/ETC.) <br />OTHER <br />NO. � 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 />RANGEHOOD <br />WATER HEATER <br />METAL FIREPLACE/STOVE <br />FIREPLACE INSERT <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUSTFAN <br />OTHER <br />I HEREBY CERITIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TPUE AND CORRECT. ALL <br />� PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TVPE OF WOFiK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />�, NOT, THE u'RANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br />STATE OR LOCAL LAW REGUTATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT 1 AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WOFK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />, CONTRACTORS LAW 78.27 RCW AND 296.200 WAC. <br />/ii�� � � S/I?�a� <br />