Laserfiche WebLink
SITE ADDRESS <br />LEGAI LOT � ! <br />DESC. <br />� <br />PERMIT APPLICATION <br />CITY OF EV�RETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 <br />PARCEL TAX I.D. # <br />� '�•z �+3�`��22 0"� Cv <br />BLOCK TRACT <br />`�jA�u��tE tST�� �����ST 4G>�2 f�t �;�`l� �i ST S�nr;t.: `i'SI�S Zv�C- 331-lSLy <br />TENANTNAME CONTACTfORPERMIT PHONE <br />�;� h <br />r�r �s �7i.;� �- �'ti; �, ti', iz�i�� <br />J ADDRESS "� � � ZIP CONTR. LICENSE # <br />CONTRACTOR 5.��.� �.��;�ar;:. 1� l�� �.l`t �:Dn, YI-<' O N , <br />Y n `�J 'i� �� - <br />PHONE <br />C1,: ``i `3 3 I Z�i c. <br />PROPOSED USE OF BUILDING , <br />;.�1l:'V,��<:� I��L��.-. ��: TYPEIT <br />1��'� ' � � <br />��, !-i.., ��ift'.b' i�u.' �. <br />CONTRACTPRICEOFWORK ,�1.{ ��-��`7J <br />WORK DESCRIPTION � � � � <br />y�t5t�����.�iG.t 7' <br />�i.��t���,r�. ��rl4�a5 <br />i:'„ _ ' . .. �i � J <br />� <br />V�%7 `,��lo�l <br />NO. I TYPE OF FIXTURE OR ITEM <br />WATER CLOSET <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK & DISPOSAL <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES V�'ASH[R <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR URAIN <br />BACKFLOW PREVENTER <br />SINK (SGRVICE/E3ARfMOP/ETC.) <br />OTHER <br />ti1-. L`� <br />P<,c',�','�,_,�..'�. �T4;0�! l <br />Building � Mechanical <br />Combinalion Plumbing wORK <br />. Demolition Sign TYPe <br />Sprinkler <br />� r <br />.i,L�C'Lu �(� <br />(•T'., Ti <br />� 1'�1-� '. 1- 1�i,'/'1 <br />j� Addition <br />�� Alteretion <br />�t New <br />v� RepaidMaint. <br />HEATSOURCE <br />n Electric <br />B Gas <br />Olher <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />%J� �I� �����%ri� <br />��, ��,-�c i � _ (,. <br />�., .�. . �. . � r.. <br />i <br />'��( �t �. iU:`��'� <br />N0. I TYPE OF FIXTURE OR ITEM <br />A/C - A/HANDLING UNITS <br />FORCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT HEATERS <br />CLOTHES DRYER <br />RANGE HOtJD <br />WATER HEATER <br />METAL FIREPLACEISTOVE <br />FIREPLACE INSERT <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUST FAN <br />OTHER <br />I HEREBY CERITIFV THAT I HAVE READ AND EXA�.�INED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF � PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br />STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 1827 RCW AND 296200 WAC. <br />% S _ i � C.. <br />DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />