Laserfiche WebLink
SITE ADDRESS <br />i-2-10 I`� <br />LEGA LOT NO. <br />TtNANTNAME <br />( <br />P�RMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />320U CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 <br />PARCEL TAX I.D. # <br />� <br />BLOCK TRACT <br />�a-� M�� <br />CONTACT FOR PERMIT <br />11 <br />�� t <br />,�: '� �' <br />, i,a <br />PERMIT # <br />ZIP PHONE <br />PHONE <br />� <br />�Yl-I�u T� Lt*�� I <br />CONTRACTOR /L ���2 �����L-h�DRESS lp ��5 `Gp�w /�_ .� ZIP CONTR. LICENSE p <br />LU�lb�lti��l� '/ <br />PHONE/' � �0�0� �Zfi��J SNot4aN-isl.� wa- �l���o I�FDU/ZCQ-0lo�o� <br />� -��O <br />PROPOSED USE OF BUILDING <br />S�rr� �e �t,wv.e� �es <br />Building <br />PERMIT B Combination <br />TYPE D Demolition <br />U Sprinkler <br />Mechanical I � Addition I HEATSOURCE <br />Plumbing WORK Alleration Electric <br />Sign TYPE New Gas <br />RepairlMaint. Other <br />CONTRACT PRICE OF WORK 2DO. � CITY OF EVEP.ETT LOCAL SALES TAX CODE IS 3105 <br />:J <br />WORK OESCRIPTION <br />�h5'�l/ 2- V�--�/e�c�A.�.�.v�--��.5 �l ��.. Lja`�-�vul-�/l in �N)r��'duY- <br />�ti•S-fu f I �.�j �{� o �P sv..� 5-h� ✓�- . <br />NO. � TYPE OF FIX7URE OR ITEM <br />WATER CLOSET (TOILET) <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 DISPOSAL <br />DISHWASI�ER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTER <br />SINK (SERVICE/BAR/MOP/ETC.) <br />OTHER <br />N0. I n'PE OF FIXTURE OR ITEM <br />A/C-A/HANDLING UNITS <br />FORCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT HEATERS <br />CLOTHES ORYER <br />RANGE HOOD <br />WATER HEATER <br />METAL FIREPLACE/STOVE <br />FIREPLACE INSERT <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PiPING <br />EXHAUSTFAN <br />OTHER <br />� I HEREBY CERI'iIFY THAT I HAVE READ AND E\v.MINED THIS AFFUCATION i�ND KNOW THE SAA1E TO OE TRUE AND CORRECT. ALL <br />i PROVISIONS OP LAWS AND ORIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPIIED WITH WHETHGR SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUAIE TO GIVE AUTHORITV TO VIOWTE UR CANCEL THE PROVISION OF ANV OTHER <br />STATE OR LOr,qL LAbV REGULATING CONSTRUC7iON OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED OY THE <br />� OWNER OF THIS PROPERTY TO PERFORI.1 THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />I CON��TORS LA1V 18.27 RCW AND 296.200 WAC. <br />�--r i l / <br />DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />