Laserfiche WebLink
SITE ApDRESS <br />LOT NO. <br />TENANTNAME <br />CONTRACf�OR n� <br />dsA�A J Q <br />PHONE � <br />PROPOSED USE OF BUILDING <br />CONTRACT PRICE OF WORK <br />P�RMIT APPLICATIdN <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - F,'UC 425-257-8857 <br />BLOCK <br />�Ci.$ <br />PARCEL TAX I.D. N <br />TRACT <br />CONTACTFOR <br />�r�A�, Id <br />ADDRESS <br />Building <br />PERIMIT Combinatii <br />TYPE Demolition <br />Sprinkler <br />S*►n <br />Mechanical <br />Plumbing <br />Sign <br />PERMIT # <br />rnoyo� -� <br />��'r PHONE <br />�44 U9tc <br />ZIP CONTR. LICENSE K <br />Additlon I HEAT SOURCE <br />Altxatlan [� Electric <br />� J(J Gas <br />Repair/Malnt. U Other <br />CITY OF EVERETT LOCAL g,LLES 7Al( CODE IS 3105 <br />wu�ac pEgGRIPTON <br />�ws i�4�1 �lA-S �ff�!qc1�. £ dA-S ��� <br />NO. � TYPE OF FI%iURE OR ITEM <br />wATER CLOSET (TOILEn <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK & DISPOSAL <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTER <br />SINK (SERVICE/BAR/MOP/ETC.) <br />OTHER <br />N0. . � TYPE OF flXTURE OR ITEM <br />AI(: — A/MANDLING UNITS <br />FORCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT HEl�TERS <br />CLOTHES DRYER <br />RANGE HOOD <br />WATER HEATER <br />METAL FIREPLACE/STOVE <br />FIREPLACE INSERT <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUST FAN <br />OTHER <br />I HEREBY CERITIFY THAT I HAVE READ ANO EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. TNE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br />STATE OR LOCAL LAW REGULO.TING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER F THIS PROP TO PERFORM THE WORK FOR WHICN APpLICATION IS MADE AND I COMPLY WITH THE STATE <br />CON O�W �.27 R W AND 296.200 WAC. <br />DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />