Laserfiche WebLink
PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES � <br /> 3200 CEDAR STREET, EVERETT, WA �8201 <br /> 425-257-8810- FAY. 425-257-8857 <br /> SITE ADDREs PARCEL TAX I.�.# PERMI7#, / <br /> .S 1� � ��� �� p�� (�`lD3'Oo <br /> LEGAL LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRESS ZIP PHONE <br /> � `� 3 ! 1 3 l 1 � c..o�,�.� �� ��— <br /> �. � � t � �.�-, <._ <br /> TENAN NAME CONTACT FOR PERMIT PHONE <br /> � I �-v�-�-'�S ��J�--�`r`�S <br /> CONTRACTOR C�f��5�7��-;}) CO�"Sr�ADDRESS (�Q `�d� I -L�/ EVp�, CONTR.UCENSE# <br /> \- lt q ��CCO� LuRTS(LCujZ S <br /> PHONE �L O I 12d��C C.wIO�;Ic( <br /> PROPOSED USE OF BUILDING fl Building Mechanica! f� Addition HEAT SOURCE <br /> PERMIT �__� Combination Plumbing WORK II��7 Alteration Electric <br /> �P�r TYPE �j Demolition Sign TYPE �j New � Gas <br /> �7a -�-L`'�Q,y�,�—S u Sprinkler U Repair/Maint. Other <br /> CONTRACT PRICE OF WORK CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> WORK DESCRIPTION <br /> �u.� 1�� 6�-s ����z ��-� �e��-et- 0�•�-5i�e_ l��\d ��`9 PrfP"'L(p�r Th� <br /> i �S�Je �,�,,._l� �a� Fa� � co�., d�� pr�e.f'S 2.Z�ur�o �3�cv �Fl �� <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 FORCED AIR SYSTEMS <br /> LAVATORY(WASH BASIN) HEAT PUMP <br /> SHOWER UNIT HEATERS <br /> _ KITCHEN SINK R DISPOSAL � CLOTHES DRYER <br /> DISHWASHER RANGE HOOD <br /> LAUNDRYTRAY WATER HEATER <br /> _ CLOTHES WASHER METAL FIREPLACE/STOVE <br /> URINAL FIREPv10E INSERT <br /> DRINKING FOUNTAIN GAS FIREPLACE <br /> F�OOR DRAIN GAS RANGE <br /> BACKFLOW PREVENTER GAS PIPING <br /> SINK(SERVICE/BAR/MOP/ETC.) EXHAUST FAN <br /> OTHER OTHER <br /> i I HEREBY CERITIFY THAT I HAV[READ AND EXAMINED THIS APPLICATION AND KNOW THE SA�1E TO BE TRUE AND CORRECT. ALL <br /> I PROVISIONS OF LAWS AND ORIDWACES GOVERNING THIS TYP�OF WORK WILL BE COMPLIED WiTH WHETHER SP'tCIFIED HEREIN OR <br /> '� NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHURIiY TO VIOLATE OF.C^dJCEL THE PROVISION OF ANY OTHER <br /> � STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. �i HAT I AM P.UTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY 1NITH THE STATE <br /> CJaflTRACTORS LAl�8,27 RCW q I p 2gg,ppp WAC. <br /> l I —���- �— 3 /� /d� <br /> �gnature of OwnedContractodAuthorized Agent Date <br /> DEBIT 8 CREDIT CARDS ARE NOT ACCEF'TED <br />