Laserfiche WebLink
.. <br /> P�F�MIT APPLICATIUN <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810- FAX 425-257-8857 <br /> SITE ADDRESS PARCEL TAX I.D.# PER�dIT p <br /> � � � /�� '� o � I o �0 6 0 o Co,3c7-ool <br /> LEGA LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRESS ZIP PHONE <br /> �r �,�.� � 1�1b..3 4C,n�. Sw..,.� <br /> TENANT NAME I CONTACT FUR PF.RMIT PHONE <br /> .� �� �;,,� �Zs 353 ta�G <br /> CONTRACTOR ADDRESS ZIP CONTR.LICENSE# <br /> PHONE <br /> PROPOSED USE OF BUIL�ING wlding I� Mechanical Addition HEAT SOURCE <br /> rn-_��b�� ��1 PERMIT Combination H Plumbing WORK R Alteration D ElecVic <br /> � 1YPE DemoliHon L/ Sign TYPE R New Gas <br /> Sprinkler �-/ RepairlMaint. Other <br /> CONTRACT PRICE OF WORK CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> WORK OESCRIPTION ���bY�l fl�1 � �vO�L � e,I•�c�+-� Q..pV�(��� <br /> V <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIX fURE OR ITEM NO.. TYPE OF FIXTURE OR ITEM <br /> X WNTER Cl OSET(TOILET) A/C-AIHANDLING UNITS <br /> L BATHTI;B _ FORCED AIR SYSTEMS <br /> �_ L:,VAi ORY(WASH BASIN) _ HEAT PUMP <br /> �. SHOWER = UNI7HEATERS i <br /> � KITCHEN SINK&DISPOSAL CLOTHES DRYER f <br /> D!SHWASHER RANGF HOOD , <br /> LAUNDRY TRAY WATER HEATER ? <br />, CLOTHES WASHER _ METAL FIREFLACE/STOVE � <br /> Uf<INAL _ FIREPLACE INSERT { <br /> DRINKING FOUNTAIN GAS FIREPLACE ^ <br /> FLOOR DRAIN GAS RANGE ; <br /> BACKFLOW PREVENTER GAS PIPING i <br /> X SINK(SERVICE/BAR/MOPIETC.) �C EXHAUST FAN <br /> OTHER OTHER � <br /> I HEREBY CERITIFY THAT 1 HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL I <br /> PROViSIONS OF IAWS AND ORIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED FiEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOL��TE OR CANCEL THE PROVISION OF ANY OTHER <br /> STATE OR LOCAI LAW REGULATING CONSTRUCTION OR THE PERFnRMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br /> OWNE OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CON A•TOR W 18.27 RCW AND 296.200 WAC. ` <br /> � 9-,�' _� 3 � <br /> i nat re of Owner/ContractodAuthonzed Agent � Date � <br /> DEBIT& CREDIT CARDS ARE NOT ACCEPTED <br /> 1 <br />