Laserfiche WebLink
r � <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 <br />SITE ADDRESS <br />i��� ll;r ; ;.� <br />IEGAL LOT M . <br />DESC. <br />OWINER <br />-�1(;S�i-�`•'- Q <br />TENANTNAME <br />CONTRACTOR (1��Q f, <br />PHONEt�'%�S) �Y3-��•��. 1 <br />PROPOSED USE OF BUILDING <br />PARCEL TAX I.D. # <br />(J'u Y3�'sy 3�7olov� <br />BLOCK. TRACT <br />�(al V� r9;n?�t f�'-.-.�"' <br />-�velc�- � ✓%f ��� <br />CONTA TFORPERMIT <br />�ia� ADDRESS 9b(�1�� ISJ��.f � <br />1-7f0-�ks�..� � L✓rr' <br />Building Mechanical <br />PERMIi � Combination Plumbiny <br />1vPE i Demolition Sign <br />Sprinkler <br />CONTRACTPRICEOFWORK `� QpU ,,,. <br />WORK DESCRIPTION �' r��` z re�1T � Cw��� ,�' <br />� J <br />NO. � TYPE OF FIXTURE OR ITEM <br />WATER CLOSET (TOILET) <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 DISPOSAL <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />UkINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTER <br />SINK (SERVICE/BAR/h40PlETC.) <br />OTHER <br />PERMIT C <br />(1n p�l c�3 - or5 <br />"le.J-K,al-l+♦ /o <br />PHONE <br />.z , N�ZIP�idS,�ONTR. LICENSE it <br />ME�rrM..� <br />TYPE <br />Addiliun <br />New <br />Rupair/Maint. <br />HEATSOURCE <br />Elec•vic <br />Gas <br />Othe� <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />N0. I 1'YNE UF FIXTURE OR ITEM <br />A/C—A/HANDL�NC IJNITS <br />�_ FORCED AIR SYS7EMS <br />HEAT PUMP <br />UNIT HEATERS <br />CLOTHES DRYER <br />RANGE HOOD <br />WATER NEATER <br />METAL FIREPLACE/STOVE <br />FIHEPLACE INSERT <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUSTFAN <br />I HERE�V CERITIFV THAT I H.4VE READ AND EX4M111NED THIS APPLICATION AND KNOW THE SAME TO �E TRUE AND CORRECT. ALL <br />i>�OVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TYPE OF WORK WILL BE COAdPLIEOIVITH 17HETHER SPECIFIED HEREiN OR <br />NOT. THE GRANTING OF A PEIiM1T DOES NOT PRESU�IE TO GIVE AUTHORIN TO VIOl�1TE OR CANCEL THE PROVISION OF ANY OTHER <br />STATc OR LOCAL LAW REGUIi�TING CONSTRUCTION OR THE PERFCR�IANCE OF CONSTRUCTION. THAT I P.d AUTHORIZED BY THE <br />0\NNER OF THIS PROPERTY TO PERFORM THE 1VORK FOR WHiC4 APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS WWf 82/RCVJ AND 29fi.200lVAC. <br />� ., , � i <br />.. I'� SignaNre of GwnenContractoriAutnonzea �pene ua�e <br />�' DE61 & CREDIT CARDS ARE NOT ACCEPTED <br />