Laserfiche WebLink
P�RMIT APPLICATIVN <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 � <br /> � 425-257-88 i u - FAX 425-257-8857 <br /> I <br /> SITE/jDDRESS PARCEL TAX I.D.# PERMIT Y I <br /> ' �> � C�a � � �// - 3/ <br /> '� � <br /> LEGAL LOT NO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRESS ZIP PHONE <br /> �-¢�.��-Gl���v� U�� ���"5 orvk� �� �x�-�� c��-a�a -� ��� <br /> TENANTNAME CONTACTFORPERMIT PHONE <br /> CONTRACTOR G�n^��'�r,��nn ADDRE55 �l.\�� ZIP CONTR.LICENSE# <br /> ,. _ . _ —� ciXaU1 C�1{P�S+f'Cf� <br /> PHONE (�� _�� � �(��G <br /> PROPOSED USE OF BUILDING f� Building fl Mechanical Addition HEAT SOURCE <br /> PERMIT K Gombination H Plumbing WORK �Alteration � Electric <br /> TYPE �...( Demolition L! Sign TYFE New Gas <br /> L> Sprinkler Repair/Maint. Other <br /> CONTRACT PRICE OF WORK CITY OF EVERETT LOCAL SALES TAX CODE IS 7105 <br /> WORK DESCRIPTI, .0� <br /> { �y„-,�-�- C�� �S <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> WATER CLOSET(TOILET) _ A/C—A/HANDLING UNITS <br /> BATHTUB FORCED AIR SYSTEMS <br /> LAVATORY(WASH BASIN) _ HEAT PUMP <br /> SHOWER UNIiHEATeRS <br /> KITCHEN SINK 8 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 DRAIN GAS RANGE <br /> BACKFLOW PREVENTER GAS PIPING <br /> SINK(SERVICE/BAR/MOP/ETC.) _ EXHAUST FAN <br /> OTHER OTt;ER <br /> I — <br /> I'� I HEREBY CERITIFY THAT I HAVE READ AND EXAMIKED THIS APPLICATION AND KNOW THE SAMc TO BE TR7E AND CORRECT. ALL <br /> � PROVISIONS OF IAVJS AND ORIDINACES GOVERNING THIS TYPE OF WORK lh'ILL BE COR1PLiED WITH WHETHcR SPECIFIED HEREIN OR <br /> INOT. THE GRANTING OF A PERMIT DOES NOT PRESU�IE TO GIVE AUTHORITY TO VIOLATE OR CANCEL TriE PROVISION OF ANY OTHER <br /> STA''E OR LOCAL LAW REGULATING CONSTRUCl ION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORI2ED BY THE <br /> � ^'NNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> �TFACTORS LAW 18.27 RCW AND 296.200 WAC. <br /> SignaWre of OwnedContracior/Authonzed Agent Date <br /> DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />