Laserfiche WebLink
P RMIT APPLICATI�iN <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810- FAX 425-257-5 57 <br /> !�=�G� '��NE ��� �v��r Tr ���� �'�o �9 <br /> SITE ADDRESS PARCEL TN( I.D.# PERM r# <br /> 2 os�� o0 00� o0 63 - � <br /> LEGAL LOTNO. BLOCF' TRACT <br /> DESC. �a � 3 f 2 <br /> OWNER AUDRESS ZIP PN NE <br /> En��`� � .�� ��� /�oF ��iNt s� ���9 ��,����5�5376 <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> CONTRACTOR ADDRESS ZIP CONTR.LICENSE# <br /> d��!' <br /> PHONE <br /> PROPOSEDUSEOFBUILDING pERM1T � Sp nkileation �i9mbinga' �E �Repair/Maint, HEATSGe�E <br /> S��� TYPE Dem01ili0n �� �� � Other <br /> CONTRACT PRICE OF WORK CITY OF EVERETT LOCAL SALES TN(CODE IS 7105 <br /> WORKDESCRIPTION .l-L7��f%!ON �� ��•v� ���' P�� <br /> �/J4i''nvN PP �"�cY 9�"3 SF To MA,"ti/ /fou� <br /> 8�/[.D d�e+ ✓e�<r %,� i� B�ac�-. <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXiURE OR ITEM <br /> WATER CLOSET(TOILET) _ A/C-A/HANOLING UNITS <br /> BATHTUB FORCED AIR Sl'STEMS <br /> LAVATORY (WASH BASIN) HEAT PUMP <br /> ,� • SHOWER UN�THEATERS <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 ORAIN GAS RANGE <br /> BACKFLOW PREVENTER GAS PIPING <br /> �rt SINK(SERVICEIBAR/MOP/ETC.) f�� EXHAUSTFAN <br /> OTHER OTHER <br /> I I <br /> � I HEREBY CERITIFY 7HAT I HAVE READ AND EXAAIINED THIS APPLICATION AND KNOW THE SA67E TO BE TRUE AND CORRECT. ALL <br /> � PROVISIONS OF L>LVS AND ORIDINACES GOVERNING THIS TVPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> i NOT. THE GRAN7ING OF A PERMIT DOES NOT PRESUh1E TO GIVE AUTHORITY TO VIOWTE OR CANCEL THE PROVISION OP ANV OTHER <br /> STATE OR LOCAL LAN'REGULATING CONSTRUCTION OR THE PERFORh1ANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORAI THE IYORK FOR WHICH APPLICATION IS h1ADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 18.27 RCLV AND 296.200 WAC. I <br /> r��Ll C.'L+it�}4 �G �J. �y I <br /> Signalure of Owner/Contractor/Authonzed Agent Date �/a <br /> DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />