Laserfiche WebLink
�� <br />SITE ADDRESS <br />LOT NO, <br />P�.�MIT APPLICATIG�� <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 <br />TRACT <br />PARCEL TAX I.D. # <br />_ �ri'� ����Tf /��it�2cc, 3�1D/ Q <br />TENANTNAME .. I CONTACTNAME <br />PERMIT d <br />%CO2./ � <br />PHONE <br />CONTRACTOR ' ADORES ZIP CONTR. LICENSE M <br />Pc�lJfklY.S�i(( �1'1t�= C�Anlcc AC �2�� ��8-�G�'-�� 2is2z�i- v`�u�F}ntsu�t c <br />PROPOSED USE OF BUIL�ING <br />p-�c"e S('Ac e. <br />CON7RACT PRICE OF WORK <br />W DESCflIPTION <br />Lo�eL — <br />(�'1u� �.��Z�� <br />- �, <br />Building Mechanical <br />PERMIT Combinalion Plumbing <br />TYPE Demolition Sign <br />Sprinkler <br />� <br />�o� �i��,e� �iu� <br />- pCv�tQ�,��� <br />iNO. I TYPE OF FIXTURE OR ITEM <br />WATER CLOSET <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 DISPOSAL <br />DISHWASHER <br />LAUNDRY TRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PRFVENTER <br />SINK (SERVICE/9AR/MOP/ETC.) <br />OTHER <br />Addition <br />WORK a.11eralion <br />TYPE New <br />RepaidMainL <br />HEATSOURCE <br />Electric <br />Gas <br />Olhor <br />CITY OF EVERETT LOCAL SAIES TAX COOE IS 3105 <br />N0. I TYPE OF FI%TURE OR ITEM <br />A!C —A/HANDLING UNITS <br />FORCF.D AIR SYSTEMS <br />HEAT PUMP <br />UNIT HEATERS <br />CLOTHES DRYER <br />RANGEHOOD <br />WATER HEATER <br />METAL FIREPLACE/STOVE <br />FIREPLACE INSERT <br />GAS FiREPLACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUSTFAN <br />OTHER <br />■� , <br />I HEREBY CERITIFY THA1 i HAVE READ AND EXAMINED THIS APPLICATION ANO KNOW THE SAME TO BE TRUE AND COFRECT, ALL <br />PROVISIONS OF LAWS AND OFIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT OOES NOT PRESUME TO GIVt AUTHORITY TO VIOIATE OR CANCEL THE PROVISION OF ANY OTHER <br />STATE OR LOCAI LAW REGUTATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCI :ON. THAT I AM AUTHORIZED BY THE <br />06VNER OF THIS PROPERTY TO PERFORAI THE WORK FOR WHICH APPLICATION IS M,4DE AND I COMPLY WITH THE STATE <br />CON7RAC➢iJRS LAW 78.�RCW ANO 296200 WAC. <br />