Laserfiche WebLink
� i <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-881U— FAX 425-257-8857 <br /> SITE AGDRE�S � PARC�L TAX I.D.# I P RMIT 9 <br /> � � � ��-�� Z-d 2 5��3io - b�� <br /> LEGAL LOT NO. BLOCK TRACT �/oe y-�/ <br /> DESC. � '�%� f�C � <br /> OWNER A�DRESS/ �" 1 A� ZIP PHONE <br /> P . - �'` __ � l�� p2h 97 d/ 503.3�.�;� <br /> TENANT NAM C NT T FO PFR 1T PHONE <br /> �f � � ��l�r�� �'1�3, 3�y:'�/6� <br /> �. CONTRACTOR ��� �� i �AI,�1� ADDRESS ��N �]IJ ZIP CONTR.UCENSE# <br /> !lN / (�//!'1 S t�/. r''�' I <br /> I PHONE 2 /' / � / O �/ / �J <br /> 7 �" � (-.l �l <br /> PROPQQQ SED U E OF BUILppp ING BUilding D Methaflical I Additian HEAT SOURCE <br /> Or������d r��n vlLp PERMIT Combination U Plumting WORK Alteration Electnc <br /> f Y � TVPe Demolition U Sign 7vPE New 7;.� �Gas <br /> j( _ �' `�v Sprinkler RepaidMain�. Other <br /> � <br /> CONTRACT PRICE OF WO K CITY OF EVERETT IOCAL SALtS TAX CODE IS 3105 <br /> WORK D CP,IPTI N <br /> �4af��rr� of��� ar�1 an�I sf���y�f�Z2�h�h� an �m�ssi�� <br /> Gvi��. /�lsL. ��ds ,�l���If� �C <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTl1RE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> WATER CLOSET A/C—A/HANDLING UNITS <br /> BATHTUB �. FORCEDAIRSYSTEMS <br /> � LHVATORY(WASH BASIN) �HEAT PUMP <br /> SHOWER � UNIT HEATERS <br /> � KITCHEN SINK&DISPOSAL _ CLOTHES DRYGR <br /> DISHWASHER RANGE HOOD <br /> LAUNDRY TRAY � WATER HEAiER <br /> CLOTHES WASHER METAL FIREPI.P,CElSTOVE <br /> URINAL FIREPIACE INSEftT, <br /> DRINKING FOUNTAIN _ GAS FIREPLACE ���� <br /> FLOOR DRAIN �-�. __ GAS RANGE <br /> BACKFLOW PREVENTER���•-_. GAS PIPING <br /> , SINK(SERVICE/BARIMOPIETC.1 � �HAUST FAN ' <br /> I _ OTHER ,_ O1"HER <br /> �I <br /> � I HEREBY CERITIFV THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br /> : PROVISIONS OF LAWS At�D ORIDINACES GOVL'RNING THIS TYPE Of WORK WILL BE COAIPLIED WITH WHETHER SPEGFIED HEREIN OR I <br /> NOT. THE GRANTING OF A PERh11T 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 AUTHORIZ[�BY THE <br /> '� OWNER O 7HIS PROP TO PERFORA7 TH WORK FOR�VI11CH APPLICATION IS 1dADE ANO I COMPLY WITH iHE STATE II <br /> �i CON 5 LAW 1 27 CW AND 296.2 AC. <br /> I ' , P� . 3p.03 I <br /> ; Signawre o Ownen Ira �, utho ed Agent Date �/ I <br /> i _ DEBIT& CREDIT CARDS ARE NOT ACCEPTED <br />