Laserfiche WebLink
0 <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 />PARCEL TAX I.D. N <br />t123 f .�c..k�r �'{jP., <br />LEGAL LOT NO. BLOCK TRACT <br />DESC. <br />TENANTNAME I CONTACT FOR PERMIT <br />MAir��1 GRI1�I05/t1crA Ivy I t%r)0 C�PLLE6o5 <br />CONTRACTOR <br />PHONE <br />ADDRESS <br />I�yJ 3�D -oo <br />p MIT <br />II M r v -o // <br />PHONE <br />ZIP CONTR. LICENSE X <br />Building Mechanical Addition HEATSOURCE <br />PROPOSED USE OF BUILDING Electric <br />+c<O ��rj,(icl PERMIT lR( Combination Plumbing WORK Altera0on Gas <br />q(i.'- I TYPE L.j DOmolilion Sign TYPE New <br />U RepairlMaint. Other <br />Sprinkler <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />CONTRACT PRICE OF WORK <br />WORK DESCRIPTION <br />..vnu wul!` AI <br />NO. I TYPE OF FIXTURE OR ITEM <br />WATER 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 (SERVICE/BAR/MOP/ETC.) <br />OTHER <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C — AIHANDLING UNITS <br />FORCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT HEATERS <br />CLOTHES DRYFR <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 HEREBY C TIFY THA"i I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS LAWS AND ORIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />SO�, THR G CATIN�G 0 EGULAON OF ANY <br />TIING CONS RUCTION OR THE PERFORMANCE OF CONSTRUCTION. ESUME TO GIVE AUTHORITY TO VIOLATE OTHAT I AM CAN::EL THE RAOUTHIORI AUTHORIZED BY OTHER <br />OWNE TIHIS OP RTY TO PERFORM THE WORK FOR WHICH APPLICATIO IS MADE AND I COMPLY WITH THE STATE <br />CONTR CT5\LA 8 RCW AND 296.20G WAC. <br />Signature of wn rl ntractor/Authorized Agent <br />Dat k JL <br />DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />