Laserfiche WebLink
6A <br />PERMIT APPLICA i)ON <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />4�2?5-257-P810 - FAX 425-257-8857 �/� ��� off) <br />z--t / <br />c5 _ <br />SITE ADDRESS ! PARCEL TAX I.D. # PERMIT 9 <br />.SJiJ <br />LEGALI LOT NO. BLOCK TRACT <br />DESC. <br />OWNER ADDRESS ZIP PHONE <br />7 <br />TENANT NAME <br />CONTACT FOR PERMIT PHONE <br />COtITRACTORJ L �- ��Ci vL7 r,j t �tC� ADDRESS S /D3 PL .01, "U j' ZIP CONTR. LICENSE # <br />/�, <br />g <br />�,., C)/ f r , <br />ETC T I�-.L .1 <br />PHONES�j� <br />7r�� <br />PROPOSED USE OF BUILDING <br />I7 Build ng Q Mechanical <br />Addition <br />HEAT SOURCE <br />PERMIT <br />TYPE <br />Combination �y Plumbing <br />Demolition U Sign <br />WORK <br />TYPE <br />Alteration <br />New <br />Electric <br />Gas <br />IIIU��S <br />Other <br />Sprinkler <br />Repair/Maim. <br />CONTRACT PRICE OF WORK <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />WORK DESCRIPTION n / 2Z.N n/�/c 11K40, /!t1 <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />NO. TYPE OF FIXTURE OR ITEM <br />WATER CLOSET (TOILET) <br />A/C — A/HANDLING UNITS <br />BATHTUB <br />_ <br />FORCED AIR SYSTEMS <br />LAVATORY (WASH BASIN) <br />_ <br />HEAT PUMP <br />SHOWER <br />KITCHEN SINK & DISPOSAL <br />_ <br />UNIT HEATERS <br />CLOTHES DRYER <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRY TRAY <br />WATER HEATER <br />CLOTHES WASHER <br />METAL FIREPLACE/STOVE <br />URINAL <br />FIREPLACE INSERT <br />_ <br />DRINKING FOUNTAIN <br />GAS FIREPLACE <br />_ <br />FLOOR DRAIN <br />GAS RANGE <br />_ <br />BACKFLOW PREVENTER <br />_ <br />GAS PIPING <br />_ <br />SINK (SERVICE/BAR/MOP/ETC.) <br />_ <br />EXHAUST FAN <br />_ <br />OTHER <br />OTHER <br />I HEREBY CERITIFY THAT I HAVE READ AND 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. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VICLATE OR CANCEL 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 OF THP PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACT S LA1V �1 yRCW AND 296.200 WAC. <br />Siynature of Owner)Contractor/Authorized Agent Date <br />DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />