Laserfiche WebLink
r <br />BMIT APVLICATILN ' <br />RMIT APPLICATILN <br />LrtY OF EVERETT <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 />�iv��eP <br />PARCEL TAX I.D. 8 <br />PERMIT N <br />17 D Sc Pv��r D� <br />��..Qn. <br />�0 ti� <br />(� �(� <br />LEGA LOT NO. <br />BLOCK <br />_ <br />TRACT <br />DESC. <br />m—.i <br />OWNER ADDRESS ZIP PHONE <br />62G Ff-vn-7 4e- S <br />TENANT NAME <br />I CONTACT NAME PHONE <br />CONTRACTOR ADDRESS ZIP CONTR. LICENSE N <br />.fig1Av3U,v PW.rlBi�(a itic 19 3 3U i3-J%E dvE .—E" <br />PHONE 4-0-L /.ti L /Ln/ 9jiLL7i /�j9/� G�F'L7 LC L <br />PROPOSED USE OF BUILDING <br />Building li Mechanical <br />Addition <br />HEAT SOURCE <br />PER Combination Plumping <br />WORK <br />I.R(�Alleralion <br />R Electric <br />$ r—Q <br />TYPE Demolition Sign <br />TYPE <br />New <br />Uj Gas <br />Sprinkler <br />Repair/Maim. <br />U Other <br />CONTRACT PRICE OF WORK �y3� <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />WORK DESCRIPTION <br />/ I-S /%4ti� F,,a..E SPLN.(GLGnZS . u S /9�2 <br />PLUMBING <br />MECHANICAL <br />NC. TYPE OF FIXTURE OR ITEM <br />NO. TYPE OF FIXTURE OR REM <br />_ <br />WATER CLOSET <br />A/C — A/HANDLINGUNITS <br />_ <br />BATHTUB <br />FORCED AIR SYSTEMS <br />_ <br />LAVATORY (WASH BASIN) <br />HEAT PUMP <br />_ <br />SHOWER <br />UNIT HEATERS <br />_ <br />KITCHEN SINK &DISPOSAL <br />CLOTHES DRYER <br />_ <br />DISHWASHER <br />RANGE HOOD <br />_ <br />LAUNDRY TRAY <br />WATER HEATER <br />_ <br />CLOTHES WASHER <br />METAL FIREPLACE/STOVE <br />_ <br />URINAL <br />FIREPLACE INSERT <br />_ <br />DRINKING FOUNTAIN <br />GAS FIREPLACE <br />_ <br />FLOOR DRAIN <br />GAS RANGE <br />_ <br />BACKFLOW PREVENTER <br />GAS PIPING <br />_ <br />SINK (SERVICE/BAR/MOP/ETC.) <br />EXHAUST FAN <br />_ <br />OTHER <br />OTHER <br />1 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 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 1 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 RCW AND 296.2C0 VAC. <br />Sgna a of Owner/�Gon ractor/Amhonzed Agent Dale / <br />Z <br />