Laserfiche WebLink
�tVA LOTNO. <br />DESC. <br />OWNER <br />�� S Q <br />TENANTNAME <br />�0.m / <br />CONTRqCTOR C �p � I <br />PHONE <br />�-(�S-3 �7- <br />PROPOSED USE OF BUILDING <br />�ERMIT APPLICAT�JN <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 <br />�� � <br />BLOCK <br />PERMIT <br />TYPE <br />--�-�••�....r�v"cvrnVRR OU <br />a '— <br />WORK DESCRIPTION ( <br />14t� O� <br />1A.� S a+c� �..o � �.�.o-..~ ) <br />NO. I 7YpE OF FIXTURE OR ITEM <br />vv.{ierccWstl (TOILE7) <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 DISPOSAL <br />DISHWASHER <br />LAUNDRY TR,4Y <br />CIOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW pREVENTER <br />SINK (SERVICE/BAF/MOP/ETC.) <br />OTHER <br />TRACT <br />PARCEL TAX 1.�. # <br />FOR PERMIT <br />ADDRESS(��'� <br />� <br />� <br />� <br />6uiiding Mechanical <br />Combination�umbing <br />Demolition Sign <br />Sprinkler <br />PERMIT # <br />P03 t �-GOZ <br />PHONE <br />rfl'Q ZIP CONTR. LICENSE # <br />g�7o <br />AdtliUon HEAT SOURCE <br />WORK R qite2tion �Electric <br />TYPE �� New Gas <br />p`•Repair/Maint. nu,e. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br />,�v,•� ,! <br />NO. I TYpE OF FIXTURE OR ITEM <br />I A/C—A/HANDLING UNITS <br />FORCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT HEATERS <br />CLQTHES DRYER <br />RANGEHOOD <br />WATER HEATER <br />METAL FIREPLACE/STOVE <br />FIREPLACE INSERT <br />GAS FIREPLACE <br />GAS RANGt <br />GAS PIPING <br />EXHAUSTFAN <br />OTHER�_ <br />�`� <br />I HEREBY CERITIFY THAT I HAVE READ AND EXAMINED THIS APPLICATIOi" AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORIOINACES GOVERNING THIS TYPE OF WO��K WILL 8E COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE G TING OF A PERAiIT DOES PJOT PRESUME TO GIVE AUTH')RITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br />STATE OR OC L LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER T S PRO ERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONT RS �k�,Z7 RCW�(j pg6.200 WAC. <br />DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />