Laserfiche WebLink
I; PERMIT APPLICATIO�� � <br /> CiTY OF EVERETT PERMIT SERVICES � <br /> i 3200 CEDAR STREET, EVERETT, WA 98201 C( -pYa� I <br /> 425-257-88 i 0- FAX 425-257-8857 <br /> i I <br /> � I <br /> � SITE ADDRESS PARCEL TN(I.D.# PERMIT� I <br /> l`1�.n ��1�\1 (' ��� �' .Y��,r 2� ,� ,. _ � �. n o� Uy- c�01 ! <br /> LEGAL LOT NO. BLOCK 7RACT i <br /> DESC. <br /> OWNER ADDRESS 21P PHONE <br /> II �,� 1 Q i <br /> �,�[C.l�n.\ Tn�11��n\(�^. . L�'� i-!�T�1 �•�:Z, j� 6c�`�-l.\` Q;l� y�7 "L LE`�� � <br /> TENA� t:AM� �— CONTACT FOR PERMIT PHONE I <br /> ��nn n �\� �"'S ��n.��c��. �O{� 1 ��k—�>� ��� I <br /> CONTRACTOR , AODRESS ZIP CONTR.LICENSE# <br /> �c �S �^55 ,a�.�.� ��V^r i.,.r,.l�- � �,r; 7_�•;� Co�.c' �!'�C�1 0�.(�`�0�� �' 4.n?'E t' � F'V`5��n <br /> PHONE <br /> `'' i -� �����— U � j)� -- <br /> PROPOSED USE 0��BUILDING Building fl Mechanical I Additicn NEAT SOURCE � <br /> PERMIT R Combinalion:�Plumbing WORK � Alteration � E�ectnc � <br /> TYPE D Demolilion lJ Sign TYPE 'Vew Gas i <br /> U Sprinklef RepaidMainL Other i <br /> CONTRACT PRICE OF WORK�- % C ��',�� CITY OF EVERETT LOCAL SALES TNC CODE IS 3105 <br /> � I <br /> WORK DESCRIPTION � \�, <br /> �. )'':.,_1 �'5�:�'CTs�cr��. .� J\�;`�� <br /> I <br /> PLUMBING MECHANICAL I <br /> NO. NPE OF FIXTURE OR ITEM NO. TYPE OF FU(TURE OR ITEM <br /> � WATER CLOSET(TOILET) _ fJC–A/HANDLING UNITS <br /> BATHTUB FORC[U AIH SYSTEMS <br /> � `� LAVATORY(WASH BASIN) HEAT PUMP <br /> � SHOWER _ UNITHEATERS � <br /> ."_ KITCHEN SINK& DISPOSAL CLOTHES DRYER <br /> �T DISHWASHER RANGE HOOD I <br /> _ LAUNDRY TRAY � 11'ATER HEATER <br /> CLOTHES'+VASHER METAL FIREPLACE/STOVE I <br /> � URINAL FIREPWCE INSERT <br /> DRINKING FOUNTAIN ! GAS FIREPLACE <br /> 3 FLOOR DRAIN GAS RANGE <br /> BACKFLOW PREVENTER GAS PIPING <br /> = SINK(SERVICE'BAW 10P/ETC.) EXHAUST FAN <br /> � OTHER , "��� = OTHER I <br /> I — — i <br /> I -- — — <br /> I I HERE81'CERITIFY THAT I HAVE REAL AND EXAMINED THIS APPLICATION AND KNOIN THE SAA-0E TO BE TRUE AND CORRECT. AlL I <br /> ' PROVISIONS OF LAVJS AND ORIDINACES GOVERNIfJG THIS T.'PE OF WORK WILL�E COMPUED�VITH WIiETHER SPECIFIED HEREIN OR , <br /> NOT. THE GRANTING OF A PERAIIT OOES NOT PRESUAIE TO GIVe AUTHORITY TO VIOWT[OR CANC,EL THE PROVISION OF ANY OTHER I <br /> �� STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORAiANCE OF CONSTRUCTION. THAT I AI.1 AUTHOR!i.ED BV THE i <br /> �i OWNER OF THIS PROPHRTY TO PERFORAd iNE WORK rOR WHICH AP-�IC.�T'CN tS MADE AND I r,OMPLY WITH TNE S'ATE ' <br /> CONTRPCTORS LAW :27 RCW AND 256.200 WAC. i <br /> ; ` � n:;��- `1 _�� _ ��- I <br /> �I Signature o OwnGYf ontractnnAuthonzed Agent Date I <br /> / <br /> � �� DEBIT & CREDIT CARDS ARE NU7 ACCEPT°D J <br />