Laserfiche WebLink
i — <br />� SIl'E ADDRESS <br />i��b �7%t� '�"` <br />ILEGAL LOT NO. <br />DESC <br />PERMIT APPLICA�ION <br />CITY OF EVE�tETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 <br />PARCEL TA% I.D. M <br />M�4C��• Jf�.sal;�ao3oc.too <br />BLOCK TRACT <br />A <br />I ��� (� / �� �� ��CZc..+nS. ... _.__ <br />; n'a"tl�'Nt��l t'ifliY�S�I '1�J� `I�O� �� �-.a �w'�>�lo <br />j TENANTNAItE CONTACTFORPERMR PHONE <br />� r`3lL-, �u�T )q�l�� I��l l�lW�h:Cl-i�GC. "Z�to Z�� �1�2``i <br />I CONTRACTOR AODRESS ZIP CONTR.UCENSE• <br />PHON: <br />PROPOSEU USE OF BUILOING <br />L�FPE���•1 <br />p�(�lF� l'� �`'a <br />COMTRACT PRICE OF WCRK <br />Building Mechenical <br />PEGlIT Combination R Plumbing <br />TVPe Demolition p S�gn <br />Sp�nklor <br />Adtlltion I HEATSOURCF <br />Altoratfon Ebc:ric <br />Now os <br />Repxir/Meint. Othor <br />CITY OF EVERETT LOCAI SALES TAI( CODE IS 7105 <br />WORKDESCRIPTION G�jS�'�.�c..� (--�G.0 �(�C�G(�i- �-(-�i.�� [—.7F�f:-F� <br />i�..L �z��si 4. �nct�fa� �(Z+�.�,� �1��c���- G-1G.� crJ4�-�`>�h��R� <br />40. � TYPE OF FlXNRE OR ITEM <br />WATER CiOS[T <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK & DISPOSAL <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES Wn�.1ER <br />n• <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />F3ACKFLOW PREV[NT[R <br />SINK (SERVICEBAR/MOPIETC.) <br />NO. I TYPE OF FI%TURE OR ITEM <br />A1C — AMANDLING UNITS <br />FORCED AIR SYSTEMS <br />HEATPUMP <br />UNIT HEATERS <br />CLOTHES DRYER <br />RANGE HOOD <br />WATER HEAT[R <br />M: TAL FIR[PLAC[/STOVE <br />FIREPLACEINSERT <br />GAS Fli EPLACE <br />GAS RANG[ <br />GAS PIPING <br />EXHAUSTFAN <br />1 MEHEBY CERITIFY 7HAT 1 HAVE NEAO AND EXAMINED iHIS APPLICA710N AND KNOW THE SAME TO BE TRUE AND COHf2ti:T. ALL <br />PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITIi WHETHER uPECIFIED HEREIN OR <br />NOT. THE ORANTING OF A PERMiT DOES NOT PRESUME TO GIVE AUTNORI7Y TO VIOIATE OR CANCE� THE PROVISION OF ANY OTHER <br />STATF OH LOCAI.IAYd KLGULAiING CONS71tUCTION ON 7HE PEI2FORMANCE OF CONSTHUCTION. THAT I AM AUTNORtZED BY THE <br />OWNEfi OF THIS PROPERiY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COAIPLY WITH THE STATE <br />CONTRACTORS LAW 16 27 RCW AND 29fi2�0 WAC. <br />Signoture o OwnedContrador/Authonzed Agent Dato <br />DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />1 <br />