Laserfiche WebLink
PERMIT APPLICATION <br />CITY' OF EVERETT PERMIT S�RVICES <br />3200 CED.4R STREET, EVERETT, WA 982J1 <br />425-257-8810 - FAX 425-257-8857 <br />SITE A jDRE55 � <br />�, <br />LEGA LOTNO. BLOCK <br />DESC. <br />OWNER <br />2l�rlDnLn/-1�. • ��i�r�,�?(L� <br />TENANTNAME <br />CONTRACTOR �!L� <br />�/v <br />PhIONE <br />PARCEL TAX I.D. # <br />TRACT <br />ACT FOR PERMIT <br />AD�RESS <br />PERMIT � <br />MO�jQ�{-0I� <br />�� ylS-��` <br />PHONE <br />ZIP CONTR. LICENSE N <br />PROPOSED USE OF BUILDING Bullding �4CChanical Addition HEAT SOURCE <br />PERMIY R COmbinatiOn'�_� Plumbing WORK Alteration Electric <br />TYPE D Demolilion �J Sign TYPE New Gas <br />U Sprinkle� Repair/M2inL Other <br />CONTRACT PRICE OF WORK <br />CITY OF EVERETC LOCAL SALES TAX CODE :S 3105 <br />WORK DESCRIPTION �� 1 s�AL �� 1 IV"I CJ � �-G� I � I— ��1J !i'-+-�`-'KJ J�U <br />NO. I IYPE OF FIXTURE OR I'fEM <br />WATER CLOSET (TOILET) <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCNEN SINK & DISPOSAL <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES bVASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTER <br />SINK (SERVICE/BAR/MOP/ETC.) <br />MECHANICAL <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C - A/HANDLING U�ITS <br />FORCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT HEATERS <br />CLOTHES DRYER <br />RANGEHOOD <br />WATER HEATER <br />METAL FIREPLACE/STOVE <br />FIREPLACEINSERT <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUSTFAN <br />OTHER <br />I HEREBY CERITIFY THAT I HAVE RFAD AND EX;IMINED THIS APPLICATION AND KNOVJ THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF lAWS AND ORIDINACES GOVERNING THIS TYPE OF WORK WILL 8E COMPLIE^ INITH WHETHER SPECIFIEU HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUM1IE TO GIVE AUTHORITY TO VIOLATE GR CANCE: THE PROVISION OF ANY OTHER <br />STATE OR LOCAL 1A41' REGULATING CONSTRUCTION OR THE PERFORPAANCE OF CONSTRI CTION. THAT I AM AUTHORIZE� BY THE <br />O`NNER OF iHIS PROPERTY TO FERFORM THE SVORK FOR WHICH APPLICATIO IS MADE .°.ND I COMPIY WITH THE STATE <br />CONTRAG�j ORS L,AW �8,27 RGj�jAN��00 `,h�AC. � � <br />DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />