Laserfiche WebLink
SITE <br />PERMIT APPLICATION <br />��j!�, CITY OF EVERETT F'ERMIT SERVICES <br />3200 CEDAR STREET, EVERETf, WA 98201 <br />425-257•8810 — FAX 425•257-8857 <br />FT� OF <br />�. Cf <br />1��i NAME�.�,� 5 ��L M <br />W A <br />BLOCK � TRACT <br />360�563-85� <br />CONTRACTOR �r�h5 �,.7a�1� <br />PFiONE <br />ZS�-5�35 <br />AROPOSED USE OF BUILDING <br />CONTRACT PRICE OF WORK <br />WORK DESCRIPTION /� `� � I <br />� <br />P�uMsin <br />N0. � TYPE OF FIXTURE OR ITE�11 <br />� WATER CLOSET <br />BATHTUB <br />� LAVATORY (WASH BASIN) <br />SHOWER <br />! KITCHEN SINK 8 BISPA9AL <br />_L DISHWASHEF <br />I.AUNDRY TRAY <br />_ CLOTHES WASHER <br />_ URINAL <br />_ DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTER <br />SINK (SERVICE/BAR/MOP/ETC.) <br />� OTHER_ /{ oye b'; h <br />PARCEL TAX I.D. R <br />I CONTACTNAME <br />i <br />�G'�Y.rADDRESS ��QU <br />� <br />H ONL� (tY�. � <br />Wp 9bz <br />a ��- <br />w� <br />Building n Mechanical <br />PERMIT Combinalion � Plumbing <br />TYPE Demolillon Sign <br />Sprinkler <br />e�e � p��pe . <br />N0. <br />rrre <br />X�L 0 <br />•EEHMIT N <br />(iC� <br />�enc <br />LP CONTR. UCENSE I <br />�B2os �—QfINSWEo�3/'N <br />Addltion <br />Alteretion <br />New <br />RepeirRdainl. <br />HEATSOURCE <br />(7 Eleciric <br />B Ges <br />Olher <br />CITY OF EVERETT LOCAL SALES TAX CODE IS J/05 <br />TYPE OF FlXTURE OR ITFM <br />A/C — A/HANDt.ING UNITS <br />FORCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT HE/1TER5 <br />CLOTHES DRYER <br />RANGE HOOD <br />WATER HEATER <br />METAL FIREPLACE/STOVE <br />FIREPLACE INSERT <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUST FAN <br />OTHER <br />I HEREOY CERITIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALl <br />PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TYPE OF WORK WILI BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT �OES NOT PRESUME TO GIVE AUTHORITY TO VIOLATL' OR C4NCEL THE PROVISION OF ANY OTHER <br />57ATE OR LOCAL LAW REGULA7ING CONSTRUCTION OR THE PERFORMANCE OF CONSTf;UCTION. THAT 1 AM AUTHO(:12ED BY THE <br />OWNER OF TI115 PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 296200 WAC. <br />Signelure ol Owner/Contrac�or/ ulhorized Agenl Dele <br />