Laserfiche WebLink
SITE ADDRESS <br />rj/ r(�t�Fs7' <br />LEGAL LOT N0. <br />�NERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, tVERETT, WA 98201 <br />425-257-8910 - FAX 425-257-8857 <br />�/G'Gc�� (�J/2. �l%��`� — <br />BLOCK TRACT <br />PARCEL TAX �.D. # <br />'/� C� T �Al�tt�tso,c� _S�i� l.c,�ss�L��`cc: <br />TENANTNAME CONTACTFORPERMIT <br />� � <br />CONTRACTOR _ ADDRESS <br />fh!A/A s .Sz�-�'es.�s - �e�2:R <br />f <br />PHONE <br />PROPOSED USE OF BUILDING <br />CONTRACT PRICE OF WORK <br />WORK DESCRIPTION <br />NO. I TYPE OF FIXTURE OR ITEM <br />N'ATER CLOSET (TOILET) <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK & DISPOSAL <br />DISHWASHER <br />LAUNDRY TRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTER <br />SINK (SERVICEIBAR/MOP/ETC.) <br />OTHER <br />Building Mechanical <br />PERMIi R Combination R Plumbing <br />TYPE Demolilion � Sign <br />B Sprinkler <br />PERMIT # <br />M o3 05-0� <br />ZIP PHONE <br />?/ �fas �as� -Py <br />?03 PHONE <br />ZIP CONTR. LICENSE # <br />Y�iYAl�j=SX/�lo n/ <br />Addilion <br />WORK Alteration <br />TYPE New <br />Repair/I ,int. <br />HEATSOURCE <br />j7 Electnc <br />B Gas <br />Other <br />CITY OF EVERETT LOCAL SALES TNC CODE IS 3105 <br />G�!�u��� /�C�T � <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C—A/HANDLING UNITS <br />FORCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT HEATERS <br />CLOTHES DRYER <br />RANGE fI00D <br />WATER HGATER <br />METAL FIREPLACE/STOVE <br />FIREPLACEINSERT <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUST FAN <br />OTHER <br />I HERE81 �. _RITIFY TH>T I HAVE READ AND EXAA4INED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF WV� ; 4ND ORIDINACES GOVERNING THIS TYPE OF WORK WILL BE CUMPUED WITH V: HETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTiNf, OF A PERMIT DOES NOT PFESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br />STATE OR LOCFL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCT�ON. THAT I AM AUTHORIZED BY THE <br />OWNEF OF THIS PROPERTY TO PERFORAI THE WORK FOR WHICH APPLICATION IS MPD° AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br />.� <br />DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />