Laserfiche WebLink
SITE ADDRESS <br />LOT NO. <br />�� <br />—i <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 � <br />BLOCK I �T <br />PARCEL TAX I.D.1t <br />Z <br />LL.�J ili CLL eaT/� %G`�Z � L�,l'N� �/�-i v � 5� Z t 3- y Z S-�ss -z �'�l _ <br />TENANT NAME CONTACT FOR PERMR P�E <br />I Lo�l�� `.T���o�r yZs-3ss-a�y <br />CONTRACTOR ADDRE35 21P CONTR. IJCENSE / <br />b �,J�� �Z <br />PHONE <br />PROPOSED USE OF BUILDING <br />s�}O �'t 4� c <br />S��'� <br />CONTRACT PRICE OF WORK <br />WORK DESCRIPTION <br />��u� Ib. rl <br />CruQtl�y <br />PERMR <br />TYPE <br />wlding <br />Combination <br />Demolition <br />Sprinkler <br />�Mechenical <br />Plumbing <br />Sgn <br />�z xi� �AI'�LL 2L'L�Y 5��lr� <br />�CL C��l.� `JI�C V <br />NO. � TYPE OF FlXTURE OR ITEM <br />WATER�CLOSET <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK & DISPOSAL <br />DISHWASHER <br />LAUNDRY TFtAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTER <br />SINK (SERVICEBAR/MOP/ETC.) <br />OTHER <br />Addition <br />Nleration <br />RepairlMeMt. <br />HEATSOURGE <br />�EleUiic <br />Gas <br />OMer <br />CITY OF EVERETT LOCAL SALES TA% CODE IS 3105 <br />NO. I 7YPE OF FD(TURE OR REM <br />AIC — AIHANDLING UNITS <br />FORCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT HEATERS <br />CLOTHES DRYER <br />RANGEHOOD <br />WATER HEATER <br />METAL FIREPLACE/STOVE <br />FIREPLACE INSERT <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUSTFAN <br />OTHER <br />I HEREBY CERITIFY TFIAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW TME 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 VIOLATE 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 THIS PROPERTV TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />ONTRACTORS LAW 18.27 RCW AND 296200 WAC. <br />�i� <br />DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />