Laserfiche WebLink
PEgMIT APPLICATIO"' <br /> �r CITY 01- EVERETT PERMIT SERV�CES <br /> 3200 CEDAR STREET, EVERETT, WA 9b2U1 K U(pQ, —C�US , <br /> 425-257•8810 — FAX 425-257-8857 <br /> � �.— _ �, ��F�� � <br /> I ('..�i E ADDRESS PARCEI TAX I.D.X � PER��tii � � <br /> ' . . �- " . •�.r�. 'i• ,�1\_ . . �i\ ' \ ' . .. . _. ;,. ` -...i_ .�t I�1 .� . <br /> ( <br /> � LEGA LOT NO. BLOCK I TRACT � � � � <br /> DESC. <br /> '�� GWNER A�DRE55 ��. ZIP PHONE � <br /> �.. . <br /> i <br /> � . � _" ..,� {_T � � ( r � ' � i �'�_'�K �I'��� � ._ . <br /> i'l <br /> � TENANT NA�AE CONTACT NAME PHONE <br /> , _ . . � i_��� � ���,,. ��' � ln � �/ `♦ ' - : ���� : —�`t{ ��� 1 <br /> � CONTRACTOR ^ AOURESS . , \ _ 2IP CONTR.LICENSE q <br /> i - - _ �) 7 . � � � �"_�I ',1 � :'-., p 1'�. _ _ _ <br /> ,_ . 1 ��_'S���L,��. -i ���� � ! ' .,` ��. �•,nT�•� .� - .-•_ � � �� <br /> T /I `- <br /> � PHONE 1 . . '� .,.� \/1 1,�,�I \ � ��k-�' '1.� i ! � ' _ . .. <br /> � V\ <br /> PROPOSED USE OF BUILDING Bwlding f'1 Mechanical Addition HEAT SOUFiCE <br /> �' PERh11T R�-.( Combination H Plumbing WORK Alteration Q E!ectric <br /> TYPE �j Demolilion LJ Sign TYPE � New U Gas <br /> iL`Z Sprinkler U Repaird.fa�nt. U Cther — <br /> . CONTRACT PFICE OF WORK • '� i (l �_,; �i � � � CITY OF EVERETT LOCAL SALES TAR COOE IS 31U5 , <br /> I <br /> � WORK OESCRIPTION <br /> . ', .,�, � �� - �� .,i . �(. �l� � �� 1. 1. ��i� �`_.j�_ ' � I <br /> i <br /> PLUMBING MECHANICAL �I <br /> NO. I TYPE QF fl%TURE OR ITEM !!O. TYPE OF FIXTURE OR ITEM11 � <br /> WATER CLOSET A/C-A/HANDLING UNITS ' <br /> BATHTUB FORCED AIR SYSTEhiS � <br /> LAVATORY (WASH BAS!N) _ HEAT PUMP � <br /> SHOWER UNIT HEATERS <br /> I<ITCHEN SINK 8 DISPOSAL CLOTHES DRYER � <br /> DISHWASHER RANGE HOOD <br /> LP,UNDRY TPAY WATER HEATER <br /> CLOTHES WASHER METAL FIREPLACE/STOVE <br /> URINAL FIREPIACE INSERT <br /> DRINKING FOUNTAIN GAS FIREPLACE � <br /> FLOOR DRAIN _ GAS RANGE i <br /> i3ACKFLOW PREVENTER _ GAS PIPING <br /> I SINK (SERVICEiBAR/MOPlETC.) _ EXHAUST FAN <br /> IIOTHER _ OTHER I <br /> ��.',.� ' � ' „�, _ � <br /> i — � <br /> I HEFE�Y CEF7ITIFY'HAT I HAVE FEAD AND EXAtdItJED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL I <br /> PROVISIONS CF L1WS AND OFIUINACES GOVERNING THIS T'fPE OF WORH WILL BE COtdPLIED WITH WHEtNER SPECIFIED HEREIN OF <br /> NOT. THE GRANTING OF A PERIAIT DOES NOT PRESUAIE TO GIVE AUTHORITY TO VIOWTE Ofl CANCEL TNE PFGVISION OF ANY OTHER �i <br /> STATE OR LOCAL L1W FEGUTATING CONSTRUCTION OR THE PERFOP.A7ANCE UF CONSTRUCTIGN. THAT I AM AUTHORIZED BY THE j <br /> 01'JNER OF THIS PPOPERTY TO PERFORM THE WORK FOF�YHICH APPLICATION IS MAOE AN� I C061P1Y WITH THE STATE � <br /> �9ACTORS lAW 18.27 RC'rV nND:90200 WAC. i <br /> � <br /> � i ' , � <br /> l �-' �ii � ; _ <br /> Sigi�awre o7(�wner/Cqntraa2orlAulhonzed Agent ale ! <br /> ' <br /> ..---- --..__---------- <br />