Laserfiche WebLink
SITE ADDRESS <br />LEGA� L� OT NO' <br />TENANTNAME <br />CONTRACTOR <br />PHONE <br />� <br />PROPOSED USE OF BUILDIN� <br />-S�Y�"�-- <br />CONTRACT PRICE Of WORK <br />WORK DESCRIPTI �N <br />P�tRMIT APPLICATIbN <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 <br />BLOCK <br />,�� i � x �'�'• ��' <br />/ / / <br />)��1 G[. yi {�i •�y, � U. i O <br />PLUMBING <br />NO. I TYFE OF FIXTURE OR ITEM <br />IVATER CLOSET (TOILET) i � <br />BATHTUB / <br />LAVATORY (WASH BASIN) N' <br />SHOWER <br />KITCHEN SINK & DiSPOSAI <br />DISHWASHER <br />LAUNDRY TR,4Y <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTER <br />SINK (SERVICE/BAR/MOP/ETC.) <br />OTHER <br />PARCEL TAX I.D. # <br />TRACT <br />ADDRESS <br />Building Mechanical <br />PERMIT � Combination R Plumbing <br />7YPE Demalition � Sign <br />Sprinkler <br />G)� � ��'� <br />/ � x .'�a� <br />�O <br />PERMIT # <br />�o �3�5 ai� <br />�7 i. � <br />� U!✓/cS/On/ S <br />� ZIP PHONE3�..��— yj68 <br />21P <br />CONTR. LICENSE K <br />�Addition <br />Alleretlon <br />New <br />RepaidMaint. <br />HEATSOURCE <br />Electnc <br />Gas �p <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />NO.. � TYPE OF FIXTURE OR ITEM <br />A/C — AIHANDLING UNITS <br />FORCED AIR SYSTEMS `"ytpo� ��" = � <br />HEAT PUMP � � ,�.� „� <br />UNIT HEATERS � <br />CLOTHES DRYER <br />RANGEHOOD <br />WATER HEATER <br />METAL FIREPLACE/STOVE <br />FIREPL4CE INSERT <br />GAS FIREPLACE Z <br />GAS RANGE ? ' <br />GAS PIPING i-" <br />EXHAUSTFA� :/ <br />OTHER <br />G.£S ? <br />I HEREBY CERITIFY TH.4T I HAVE READ AND EXAMINED THIS APP�ICATION AND KNOW THE SAME TO BE TRUE ANO CORRECT. ALL <br />PROVISIONS OF LAWS AND ORIDINACES GOVERNING TI11S TYPE OF WORK WI! L BE COMPL�ED WITH WHETHER SPECIFIED 4EREIN OR <br />NUT. THE GRANTING GF A PERMIT DOcS N07 PRESUMF TO GIVE AUTHORITY TO VIOtATE OR CANCEL THE PROVISION OF ANY OTHER <br />SThTE OR LOCAL LAW REGUL4TING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OYJNcR OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRFCTORS LAW 18.27 RCW PND 296.200 WAC. <br />DEBIT & CReDIT CARDS ARE NOT ACCEPTED <br />