Laserfiche WebLink
�- �'"o S ,� <br />`rERMIT APPLICAT �ON <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERElT, WA 98201 <br />, , �25-257-8810 - FAX 425-257-8857 <br />SITE ADDRESS PARCEL TAX I.D. M <br />�-� !- O � S �T/� S / � �f-v <br />BLOCK <br />DESC. <br />TRACT <br />PERMIT M <br />C c�3c <br />40D9ESS ZIP PHONE <br />,s%FR o �- l7 !=� i� P �! c 8 13T/f ST S�Ya Gv�- 3 6a �F � 5%%- <br />TENANTNAME I CONTACTNAME PHONE <br />CONTRACTOR <br />PHONE <br />PROPOSED US � r ILDING <br />, <br />� ,� <br />�5 %�7G�� c�= <br />CONTRACT PPoCIE OF WORK <br />AD�RESS <br />Building ['� Mechanical <br />PERMIT R Combination B Plumbing <br />TYPE D Demolition Sign <br />I� Sprinkler (s ol heatls) <br />� <br />ZIP CONTR. LICENSE N <br />RAddition I HEATSOURCE <br />Altaration � Electric <br />BNew Gas <br />RepairlMaint. Other <br />CITY OF EVEREIT LOCAL SALES TAX CODE IS 3105 <br />WORK DESCRIPTION -��' - n � '� \-� <br />(/''r�ti"�-'�' � - /«i �� ( f— �`'����'� <br />��✓� ��� � <br />NO. I TYPE OF FIXTURE OR ITEM <br />WA��ER CLOSET (TOILET) <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK & DISPOSAL <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOU?!TAIN <br />FLOOR DRAIN <br />BACKFLOW PREVE�NTER <br />SINK (SERVICE/BAf,'MOP/ETC.) <br />OTHER <br />N0. I TYPE OF FI%TURE 7R ITEM <br />I - <br />� �_ <br />� �`,� � ` <br />`� <br />I HEREBY CERITIFY THAT I HAVE READ AN� EXAMINED THI <br />PFiOVIS10NS OF LAWS AND ORIDINACES GOVERNING THIS <br />� NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TG <br />STATE OR LOCAL LAW REGULATING CONSTRUC710N OR TH <br />'i OWNER OF THIS PROPERTY TO PERFORId THE WORK FOR N <br />ii CONTRACTORS LAVJ 1827 RCW AND 296200 WAC. <br />� �i . . � <br />� �� (q� +�-� ` <br />//,I,,i � .� ....,CORRECT. ALL <br />// //� !� � ( ..nclHER SPECIFIED HEREIN OR <br />u T�t /-Ll'f _..n CANCEL THE PROVISION OF ANY OTHER <br />V .,�-�ONSTRUCTION. THA� IAMAUTHORIZEDBYTHE <br />..� r ICATION IS MADE AND I COMPLY WITH THE STATE <br />Z . ��0� <br />� U3�o2�oc)7 <br />