Laserfiche WebLink
,-- f( =RMIT APPLICAT: )N <br /> � CITIf OF EVERETT PERMiT SERVICES <br /> .._ 3200 CEDAR STREET, EVERETT, WA 98201 , 425-257-8810 <br /> C K2G 14 <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT# <br /> ;S?; KROMC-R AVG BVL'RLTT. \yA 9R201 00801900005G00 rn�5��i 'G� <br /> LEGAL LOT NO. BLOCK ITRACT <br /> DE <br /> OWNER ADDRESS PHONE <br /> IiARCHGNKO,SIiIRLHY 38�3 KROMGR AVG (q25)352-9720 <br /> • 6VGRGTT, WA 98201 <br /> TENANT NAME CONTACT NAME PHONE <br /> PAMGLA I�IILL 425 8I4-3124 x133 <br /> CONTRACTOR ADDRESS CONTR.LICENSE# <br /> PAST WATGR IIGATGR COMPANY 12601 132ND AVG NG PASTWHf'052D� <br /> (425)AW-3I2d KIRKLAND, WA 98034 02/IG;.'.OU7 <br /> PROPOSED USE OF BUILDING Bu(Idinp Maehanica WORK Addilion HEAT SOURCE <br /> PERMIT Combination Plumhing Alteretion �Electric <br /> TypE Damolilion Sign TYPE New as <br /> r I r Re alrlMalnl ther <br /> CONTRACT PRICE OF WORK $q49.00 CITY UF EVERETT LOCAL SA!ES TAX CODEIS 3105 <br /> WORK DESCRIPTION �temove/lic,lace Gns Waier I Ica�cr <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> _______ WATER CLOSET _____._ A1C-A/HANDLING UNITS <br /> ____ BATHTUB �____ FORCEO AIR SYSTEMS <br /> ____ LAVATORY (WASH BASIN) _____ HEAT PUMP <br /> ___ SHOWER ___ UNIT HEATERS <br /> _ __ KITCHEN SINK & DISPOSAL _,___ CLOTHES DRYER <br /> ___ DISHWASHER __ _ RANGE HOOD <br /> ____ LAUNDRY TRAY __�__ WATER HEATER <br /> __ CLOTHES WASHER ____ METAL FlREPLACEISTOVE <br /> __ URINAL _�__ FIREPLACE INSERT <br /> __ DRIIIKING FOUNTAIN _Y_ GAS F9REPLACE <br /> __ FLOOR DRAIN ____ GAS RANGE <br /> ___ BACKFLOW PREVENTER ___ GAS PIPING <br /> ___ SINK (SERVICE/BARIMOPIETC.) ___ EXHAUST FAN <br /> -- - <br /> ----- OTHER�-- ---- OTHER------------------- <br /> 1 HEREBY CERTIFY THAT I HAVE READ AND EXAM�NED THIS APIICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> PROVISIONS OF LAWS ANO ORDINANCES GOVERNING THIS TYPE O�WORK WILL BE COMPLIED WIHT WHETNER SPECIFIED HEREI <br /> OR NOT.THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STATE OR L�CAL LAW REGULATING CONSTRUCT�ON OR THE PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED <br /> BY THE OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STA'fE <br /> CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br /> Signatura o(OwnedContractorlAuthorized Agem .�,. . ;�'� � Date 08/03/2005 <br /> ui oqi <br />