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 7 `�3 �t ' I <br /> '"I <br /> � SITE ADDRESS PARCEL TAX I.D.# P h��T� I <br /> �70� pA����� �v�. �d Llo� �i � ' <br /> LEGAL LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRESS ZIP PI10NE <br /> �� D/'i0 C�O���.L (�5�5��q 1�r ►1 E Marys�r'l�� ��2.70 (31.� (,57 5� 5 <br /> TENANT N� CONTACT FOR PERMIT PHONE <br /> / / � _ ' ,. . __ <br /> I �,r�r'� <br /> CONTRACTOR AODRESS ZIP CONTR.LICENSE# <br /> lon,/ �,�cr.� �c� l8 �ayo9 <br /> PHONE`� 3,�� 1�� W 1 0 I �/�j v�Cl�)'C A V Z %ff�d 1 <br /> PROPOSED USE OF BUILOING I� Building Mechanical �l Adtlition HEAT SOURCE <br /> PERMIT �-� Combination � Plumbing WORK r) niteration � Eiectric <br /> ; TYPE �� Demolition Sign TYPE D New Gas <br /> i L] Spnnkler U RepaidMaint. Other <br /> CONTRACT PRICE OF WORK CITY OF EVERETT LOCAL SALES TAX CODE IS J105 <br /> WORK DESCRIPTION �l�t il L, 1 �� � � ACC C js �C(,yy�,� � <br /> � h'In''v�'�`n � <br /> -- PLUMBING PlIECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> \NATER CLOSET(TOILET) _ AIC–NHANDLING UNITS <br /> BATHTUB _ FORCED AIR SYSTEMS I <br /> LAVATORY(WASH BASIN) _ HEAT PUMP Ii <br /> SHOWER _ UNITHEATERS i <br /> KITCHEN SINK 8 DISPOSAL _ CLOTHES DRYER �I <br /> DISHINPSHER _ �NGE HOOD <br /> LAUNDRY TRAY _ WATER HEATER i <br /> CLOTHES WASHEF _ METAL FIREPLACE/STOVE I <br /> URINAL _ FIREPLACE INSERT <br /> — GAS FIREPLACE I <br /> DRINKING FOUNTAIN — <br /> FLOOR DRAIN _ GAS RANGE <br /> BACKFLOW PREVENTER GAS PIPING <br /> i SINK(SERVICErBAR/MOP/ETC.) _ EXHAUST FAN <br /> I OTHER _ OTHER <br /> ' I HER[BV CERITIPY 7HAT I HAVE READ AND E.YA�4INED THIS APPUCATION AND KNOW THE SAME TO BE TRUE ANG CORRECT. ALL I <br /> PROVISIONS OF LAVJS AND ORIDINACES GOVERNING THIS TYPE OF WORK�l'ILL BE COA7PLIED 1NITH WHETHER SPECIPIED HEREIN OR <br /> NOT. THE GRANTI�G OF A PERNIT DOES NOT PRE�UME TO GIVE AUTHORITY TO VIOW iE OR CANCEL 7HE?ROVISION OF ANY OTHEF � <br /> i <br /> � STATE OR LOCAL�1'J REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I Ah7 AUTHORIZED BV THE I <br /> ' OWNER OF THIS PROP TY TO PERFORId ThE WORK FOR�1'HICH APPLICATION IS�dADE AND I COMPLY WITH THE STA�E <br /> CONTRPCTORS ��+�jj)///yyy1 .27 RCW AND�96.200 WAC. � <br /> �'i / / ���le���6/'�� 1 <br /> ' Signature ot OwnedContractorlAuthonzed Agent Date /a, <br /> DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED ' <br />