Laserfiche WebLink
P�cRMIT APPLICATII�N <br /> CITY OF EVERETT PERMIT SERVICES �,�, � � <br /> 3200 CEDAR STREET, EVERETT, WA 98201 ���` <br /> 425-257-8810- FAX 425-257-8657 <br /> SITE AD RESS„ � �7 PARCEL TAX I.D.N � PERMIT x <br /> � -== I / C�;' ��i �'���°-� �O3 - <br /> L GA LOT NO. BLOCK TRACT <br /> DESC. �� � <br /> OWNER AODRESS ZIP PXONE <br /> ��� � �`��� /� /J'� G v �� � �i� �!'�C�) �� ���<S�L�1 "� G�� ��7� � ��os <br /> TENANT NAME CcbNTACT NAME P ONE <br /> � � o g�-� 9/ -/ <br /> CONTRACTOR ADDRESS LP CONTR.LICENSEN <br /> PHONE � � ��L� ��L%� <br /> PROPOSED USE OF BUILDING � , Building f"1 Mechanical Addition HEAT SOURCE <br /> ., c�� PERMIT Com6ination K Plumbing WORK Alleration � Electric <br /> � � � TYPE Demolition L) Sign TYPE New Gas <br /> /` �` �� - l�(:� !1 � Sprinkler Repair/Maint. Olhar <br /> CONTRACT PRICE OF WORK CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> WORKDESCRIPTION l, �. � �, q �" _ ;;, ���^��—I � �, �. �-'j L i f %�- ��C �'c_ G C�c� <br /> i�� � <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF F�XTURE OR ITEM NO. TYPE OF FlXTURE OR ITEM <br /> WATER CLOSET A/C—A/HANDLING UNITS <br /> BATHTUB FORCED AIR SYSTEMS <br /> LAVATORY(WASH BASIN) HEAT PUMP <br /> SHON.�ER UNIT HEATERS <br /> KITCHEN SINK 8 DISPOSAL CLOTHES DRYER <br /> DISHWASHER RANGE HOOD <br /> LAUNDRYTRAY WATER HEATER <br /> CLOTHES WASHER METAL FIREPLACE/STOVE <br /> URINAL _ FIREPLACE INSERT <br /> DRINKING FOUNTAIN _ GAS FIFitPLACE <br /> FLOOR DRAIN GAS RANGE <br /> BACKFLOW PREVENTER GAS PIPING <br /> SINK (SERVICE/BAR/MOP/ETC.) EXHAUST FAN <br /> OTHER OTHER <br /> I HEREBY CERITIFY THAT I HAVE READ AND EXAh1�NED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br /> PFOVISIONS OF tAINS AND ORIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPI.iED WITH WHEfHER 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 I AM AUTHORIZEO 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 1827 RCW AND 296.200 WAC. <br /> %� � . —' '' �� , .i �' / `� <br /> ��: :-'' "�- �:''1,��---c. - --���� ��C ���- (� / <br /> SignaWfe ol Owne�/Contractor/Authorized Agent Date ` f _\ / <br /> \,!`�1 � L <br /> V <br />