Laserfiche WebLink
PLRMIT 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 1?3 J3 PARCEL TAX I.D. # <br />i r19—t <br />LEGAL LOT NO. BLOCK TRACT <br />DESC. <br />OWNER , <br />DDRESS <br />D 0/\( 1.3 S� 1 I C L <br />TENANT NAME <br />CONTRACTOR <br />PHONE • : - / Ct - ---L'i S / <br />CONTACT FOR PERMIT <br />Jos zAr,a <br />ADDRESS <br />4 <br />PERMIT # <br />HONE <br />3c o- i65-�3.5-5' <br />ZIP CONTR. LICENSE # <br />Pvge"T 5P033 <br />Building <br />g <br />Mechanical <br />Addition <br />HEAT SOURCE <br />PROPOSED USE OF BUILDING <br />PERMIT Combination <br />Plumbing <br />Sign <br />WORK <br />TYPE <br />Alteration <br />New <br />Electric <br />� Gas <br />I <br />u T 3 L- 1- /_ a b <br />/ <br />TYPE Demolition <br />Repair/Malnt. <br />Other <br />�id <br />Sprinkler <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />CONTRACT PRICE OF WORK <br />WORK DESCRIPTION <br />,jw5Tal/ '! ry11w S/A,k5 / / Nc7 w 17e, T"'K A/AT. C�»I ��'vi�� vr..cr3 <br />PLUMBING <br />NO. TYPE OF FIXTURE OR ITEM <br />MECHANICAL <br />NO. 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 />T <br />/ <br />_EXHAUST <br />_2 <br />A/C- A/HANDLING UNITS <br />FORCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT HE RS <br />RY <br />CLOTHESS DRYER <br />RANGE HOOD <br />WATER HEATER <br />METAL FIREPLACE/STOVE <br />FIREPLACE INSERT <br />GAS FIREPLACE <br />GAS RANGE CC ,/" <br />GAS PIPING <br />FAN <br />OTHER I3u' >e Cjv/a ar5 <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />— <br />_ <br />I HEREBY CERITIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THt bAMt i v nt i nuc nrvi+......�.....• <br />PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br />STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 296.200 WAD. <br />/? /._ 7— 7 —� 3 <br />DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />