Laserfiche WebLink
P 'RMIT APPLICATI � N <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STRE�T, EVERETT,WA 98201 <br /> 425-257-8810— FAX 425-257-8857 �/ LI(�� —b03 <br /> J� <br /> SITE�DDRESS PARCEL TAX I,D.M PERMIT a <br /> U �'z D `1 °I6 � 3�3 0 0 0 � vo <br /> LEGA LOTNO. flLOCK TRACT <br /> DESC. <br /> OWNER AOURESS ZIP PHONE <br /> TENANT NAME CONTACT FON PERMR PNONE <br /> CO�CTOR`��C PCIM+l3 N�U �DRESS $�I� /4y�y�(.Nf' ZIP CONTR.LICENSEk <br /> PHONE {�NSV�• �vi1 I�7�� A-UICN�-o�sNDy <br /> Cru �y? f� � 7Sy-�S�b ors��. (�b�) (,S'3- �yrf <br /> PROPOSED USE OF BUILDING R Building fI��1 Mecha�(cal Additlon HEAT SOURCE <br /> P�E1T LJ SPnnAlle non p.( S(gn bin8 7YPE RePaitllMalnt. LJ Oectric <br /> LI <br /> CONTRACT PRICE OF WORK � LG� CITY OF EVERETT LOCAL SALES TAX CODE IS�105 <br /> n <br /> WORK DESCRIPTION <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF FIXTURE OR ITEM N0. TYPE OF flXTURE OR ITEM <br /> � WATERCLOSET(TOILET) A/C—A/HANDLINGUNITS <br /> BATHTUB FORCED 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 FIREPLACE/STOVE <br /> URINAL FIREPLACE INSERT <br /> DRINKING FOUNTAIN GAS FIREPLACE <br /> FLOOR DRAIN GAS RANGE <br /> � BACKFLOW PREVENTER GAS PIPING <br /> � SINK(SERVICE/BAR/MOP/ETC.) EXHAUST FAN <br /> � OTHER I,vMna t a _ OTHER <br /> (irr�=o n a�fti <br /> I HEREBY CERITIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW TNE SAME TO BE TRUE AN�CORRECT. ALL <br /> PROVISIONS OF LAWS AND ORIDINACES GOVERNING TNIS TYPE OF WORK WILL BE COMPLIED WITH WNETHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEI THE PROVISION OF ANY OTHER <br /> STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br /> OWNER TNIS PROPERTV TO PERFORM THE WORK FOR WHICN APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONT RS LAW�]� 8.27 CW AND 29fi.200 WAC. <br /> L � � � <br /> S' re o OwnedContracror/Authorized Agent Date <br /> DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />