Laserfiche WebLink
F9i7�_1�17.1��9 <br />LOT NO. <br />ERMIT APPLICATI�UN <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 <br />i� r a <br />BLOCK TRACT <br />� C�-1 r(S W f� I'T� <br />TENANTNAME <br />�`d� �--� <br />CONTRACTO��! � <br />l� <br />PHONE ^ �� ^ ^ 2 ( <br />r�C� !-�4j <br />PROPOSED USE OF BUILDING <br />PARCEL TAX I.D. # <br />�� <br />CONTACTFOR <br />ADDRESS <br />Building Mect <br />PERMIT � Combination lurr <br />TYPE Demolition Sign <br />Sprinkler <br />CONTRACT PRICE OF WORK �` C� �� � OU <br />WORK DESCRIPTION <br />--�5�-< < �L'��u► -t <br />t�',ryav�T t¢t3 �� X c�2y <br />NO. I T1'PE OF FIXTURE OR ITEM <br />WATER CLOSET (TOILET) <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK & DISPOSAL <br />DISHWASHER <br />LAUNDRY TRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTER <br />SINK (SERVICE/BARIMOPIETC.) <br />OTHER <br />rtrtn�i �_ �O� <br />) 9d � i'Y� <br />ZIP PHONE <br />i�i' 1�Zs�3 �Z5 3S3 31L� <br />PHONE <br />ZIp CONTR. LICENSE M <br />w�-s �fr�r�tocw <br />n Atldition <br />I—S p��eraUon <br />�_� New <br />IJ RepaluMaint. <br />HEATSOURCE <br />ElecVic <br />Gas <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />'j�C� I�( (� <br />z t� � <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C—A/HANDLING UNITS <br />FORCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT HEATERS <br />CLOTHES DRYER <br />RANGE HOOD <br />WATER HEATER <br />METAL FIREPLACE/STOVE <br />FIREPLACE INSERT <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUST FAN <br />OTHER <br />I HEREBY CERITIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNO�V THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF fAWS AND ORIDINACES GOVERNING THIS.TYPE OF WORK WILL BE COMPLIED WITH W� �7HER SPECIFIED HEREIIJ 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 PERFORA7ANCE 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 />CON�TORS �� RCW AND 296 �O�Aj <br />AA�J�c �M/L�1 �/'� ��GC� � �S/d � <br />DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />