Laserfiche WebLink
( <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 /> SIT i AD�SS ��eZD I PARCEL TAX I.D.# RM�Tj# �, m� <br /> � � � Q.s��+{.J <br /> LEGA LOT NO. , BLOCK TRACT <br /> DESC. YJ <br /> OWNER qCtSh �'C--k�T,{�ay 6 C�qb��RES�o� a�,�y ZIP PHONE <br /> ��resh K•-� N.�e.\arn CM�t�0.b�S �Vs�.R -�3��c ��Z� y2s'�59 -o� <br /> TENANTNAME �aV0.RC.Q.G� CONTACTFORPERMIT �.ZS_��b_i�cjl� PHONE <br /> `�',\� �-Cr�e.e o �' ��\\ ��h yz.s -�}�- -��log <br /> CONTRACTOR �nknpW ��S��M��DRESS ZIP CONiR.LICENSEt1 <br /> PHONE ���Q,,,M,� <br /> PROPOSED USE OF BUILDING r�7n�y uilding � Mechanical Additlon HEAT S�URCE <br /> M��;n���� PERMIT �ombination Plumbing WORK �eration [IyElecuic <br /> 7YPE Demolition Sign TYPE New D Gas <br /> Sprinklef RepaidMaint. U Other <br /> CONTRACT PRICE OF WORK 1 � 5�� CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> WORK DESCRIPTION <br /> 7�' - -�Or- /nac�� B�,�O� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO.. TYPE OF FIXTURE OR ITEM <br /> WATER CLOSET(TOILET) AIC—A/HANDLING UNITS <br /> BATHTUB FORCED AIR SYSTEMS <br /> LAVATORY(WASH BASIN) HEAT PUMP <br /> SHOWER UNIT HEATERS <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 /> OOR DRAIN GAS RANGE <br /> OW PREVENTER � }- � _ GAS PIPING <br /> = SIN ERVICEIBAR/MOPIETC.) �Q/�,QU�1'Jq]' _ EXHAUST FAN <br /> OTHE / U _ OTHER <br /> — � — <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 PERh11T DOES NOT PRESUME TO GIVE AUTHORITY TO VIOIATE OR CANCEL TNE PROVISION OF ANY OTHER <br /> STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORAIANCE OF CONSTRUCTION. TNAT 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 296200 WAC. <br /> ��/:�-;,ti, 21�� S-/S•c� 3 <br /> SignaWre o(OwnedContractorlAuthonzed Agent Date 6/ <br /> DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />