Laserfiche WebLink
PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 <br />SITE ADDRESS <br />PARCEL TAX I.D. # <br />PERMIT # <br />Po�{o3 03� <br />,1-:,)4 z3 6 rand 1f )e <br />LEGA LOT NO. <br />BLOCK <br />TRACT <br />DESC. <br />OWNER ADDRESS ZIP PHONE <br />�( %� 6,f Z zs 7ti/S <br />�\ L/G/I)/e- t� S Z. IP1� 'Z3 r�i-/u nt♦° �1r,' %ty�JI <br />TENANT NAME CONTACT FOR PERMIT PHONE <br />CONTRACTOR ADDRESS ZIP CONTR. LICENSE # <br />PHONE <br />PROPOSED USE OF BUILDING <br />Fi <br />I{LKJ�( <br />Building Fi Mechanical <br />Addition <br />Alteration <br />HEAT SOURCE <br />RR Elecvc <br />PERMIT <br />Combination Plumbing <br />WORK <br />5 <br />TYPE <br />IIL--(S/ <br />Demclition Sign <br />Sprinkler <br />TYPE New <br />Repair/Maint. <br />�j Gas <br />LB Other <br />CONTRACT PRICE OF WORK <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />WORK DESCRIPTION / <br />&r <br />s K-sk-� <br />0 <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />NO. TYPE OF FIXTURE OR ITEM <br />WATER CLOSET (TOILET) <br />_ <br />A/C - A/HANDLING UNITS <br />_ <br />BATHTUB <br />_ <br />FORCED AIR SYSTEMS <br />_ <br />LAVATORY (WASH BASIN) <br />_ <br />HEAT PUMP <br />_ <br />SHOWER <br />_ <br />UNIT HEATERS <br />_ <br />KITCHEN SINK & DISPOSAL <br />_ <br />CLOTHES DRYER <br />_ <br />DISHWASHER <br />_ <br />RANGE HOOD <br />_ <br />LAUNDRY TRAY <br />_ <br />WATER HEATER <br />_ <br />CLOTHES WASHER <br />_ <br />METAL. FIREPIACE/STOVE <br />_ <br />URINAL <br />_ <br />FIREPLACE INSERT <br />_ <br />DRINKING FOUNTAIN <br />_ <br />GAS FIREPLACE <br />_ <br />FLOOR DRAIN <br />_ <br />GAS RANGE <br />Z <br />BACKFLOW PREVENTER <br />_ <br />GAS PIPING <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 PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br />NOT. THE GRANTING OF A PERMIT DOES <br />STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 296.260 WAC. <br />Signature of Owner/Contractor/Authorized Agent Date <br />DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />