Laserfiche WebLink
PL��MIT APPLICATI�J <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810- FAX 425•257-8857 <br /> SITE ADDRESS PARCEL TAIf I.D.N PERMI7 M <br /> --� r �v � .s�Zoq-o � <br /> LEGA LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNE ADDqES3 ZIp pHONE <br /> �er ✓'Q �� I��O I ���r��—� �'��5�f l N21 <br /> TENANTNAME I CONTACTNAME PHONE <br /> CONTRACTOR AUDRE55 AP CONTR.LICENSEM <br /> PHONE <br /> PROPOSED USE OF BUILDING I Building n Mechenical Addition MEAT SOURCE <br /> PERMIT R Comhination H Plumbing WORK RI..1 Al�era�ion [� Electric <br /> TYPE D Demolition L� Sign TYPE �j New u Ges <br /> �� Spnnkler U aepair/Meinl. I, Other <br /> CONTRACT PRICE OF WORK CITY OF EVERETT LOCAL SALES 7A%CODE IS 3105 <br /> WORK DESCRIPTION <br /> re�IQU V�� � � t�0 0� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FlXTURE OR REM N0. TYPE OF flXTURE OR ITEM <br /> _ WATER CLOSET _ q/C—A/HANDIING UNITS <br /> _ BATHTUB _ FORCED AIR SYSTEMS <br /> _ LAVATORY(WASH BASIN) _ HEAT PUMP <br /> I _ SHOWER _ UNIT HEATERS I <br /> _ KITCHEN SINK 8 DISPOSAL _ CLOTHES DRYER <br /> _ DISHWASHER _ RANGE HOOD <br /> I _ LAUNDRY TRAY _ WATER HEATER <br /> _ CLOTHES WASHER _ METALFINEPLACE/STOVE <br /> I _ URINAL __ FIREPLACE INSERT <br /> _ DRINKING FOUNTAIN _ GAS FIREPLACE <br /> � _ FLOOR DRAIN _ GAS RANGE <br /> _ BACKFLOW PREVENTER _ GAS PIPING <br /> _ SINK(SERVICE/BAWMOP/ETC.) _ EXHAUST FAN <br /> � _ OTHER _ OTHER <br /> � — <br /> I <br /> � I HEREBY CERITIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND COHRECT, ALL <br /> ; PROVISIONS OF LAWS AN�ORIDINACES GOVERNING THIS TYPE OF WORK W�LL BE COMPLIED WITH WHETHER SPECIFIED HEFEIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHOPITY TO VIOIATE OFi CANCEL THE PROVISION OF ANY OTHER <br /> STATE OR LOLAL L4W REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. TNAT I AM AUTHORIZED BY THE <br /> OWNER OF Th115 PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH TNE STATE <br /> CONTRACTORS RCW 6.200 WAC. <br /> Signawre o Owne/Contr or \oni Agent �C e�g D� <br />