Laserfiche WebLink
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 A�DRESS PARCEL TAX I.D.# PERMIT» <br /> /H7�1 lro�t/��a,. Do s'/ g�do � , 00 <br /> LEGA LOT NO. BLOCK TRACT <br /> DESC. I a � Z � ''� I L �OrU$ 'a °vP 0 !7�'�� _ <br /> OWNER ADDRESS ZIP PHONE - <br /> � 1.�22Y `SD�i,�so�� <br /> TENANTNAME I CONTACTNAME PHONE <br /> CONTRACTOR �K� G��' S7�lc�(G��DRESS �/G iJ. C�A� LP CONTfl.LICENSEA <br /> PHONE <br /> PROPOSE�USE OF BUIL�ING Building � Mechanical Addilion� HEAT SOURCE <br /> Owy{� � M.J u v i 7 PEHMIT � Combination Plumhing WORK �Alleralion � Electric <br /> TYPE Demolitlon Sign TYPE New Gas <br /> Sprinkler Repair/Maint. Olher <br /> CONTRACT PRICE OF WORK CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> WORKDESCPIPTION {��PAi2 �:�R�j- Of�W(y/t� <br /> 1� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR REM NO. TYPE OF FlXTURE OR REM <br /> WATERCLOSET _ A/C—A/HANDLINGUNITS <br /> BATHTUB _ FORCED AIFi SYSTEMS <br /> LAVATORY (WASH BASIN) _ HEAT PUMP <br /> SHOWER _ UNIT HEATERS <br /> KITCHEN SiNK 8 DISPOSA� _ CLOTHES DFYER <br /> OISHWASHER _ RANGE HOOD <br /> LAUNDRY TRAY _ WATEfl HEATER <br /> CLOTHES WASHER _ METAL FIREPLACE/STOVE <br /> i _ URINAL _ FIREPLACE INSERT <br /> ' DRINKING FOUNTA�N _ GAS FIREPLACE <br /> I _ FLOOR�RAIN _ GAS RANGE <br /> � _ BACKFLOW PREVENTER _ GAS PIPING <br /> i SINK (SERVICE/BAR/MOP/ETC.) _ EXHAUST FAN <br /> OTHER _ OTHER <br /> I HERE9Y CERITIFY'HAT I HAVE READ AND JCAtdINED THIS APPIICATION AND KNOW THE SAME TO BE TRUE AND COARECT. ALL <br /> PROVISIONS OF WWS AND OFiIDINACES GOVEflNING THIS TYPE OF WORI(WILL BE COMPIIED WITH WHEfHER SPECIFIED HEREIN OR <br /> MOT. THE GRANTING OF A PERMIT DOES NOl'PRESUME TO GIVE AUTHORITY TO VIOIATE OR CANCEL THE PFOVISION OF ANY OTHEN <br /> STATE GR LOCAL LAW REGUL.ATING CONSTRUCTION Ofl THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS M:1DE AND I COMP'..Y WITH TF'.E STATE <br /> GONTFACTORS LAW i8.27 RCW AND 296.200 WAC. <br /> Signature of Owner/Contractor/Authorized Agent Date <br /> �O� -�' �, P�� P�v:r�rq p , 1�u Ov��� - AJo ���� �v� <br /> � � � � Y3as�e �e� <br />