Laserfiche WebLink
( <br /> PERMIT APPLICATION <br /> CITY OF EVER�TT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810- FAX 425-257-8857 <br /> SITE ADDRESS PARCEL TAX I.O.# PEF�MIT p <br /> ao � oo `�D-3 -oa -ao " dJ -vo� <br /> ESC. ;OTNO�^� BLOCK TRACT �'G� o� �tJe�'ct�' pl�ll 1UY� \,L/" <br /> � � o( �I <br /> OWNER ADDRESS 21P PHONE <br /> �1c:w��GJ '� �'�`l \�.�"W1LY� t��O IRJe.�y✓lLY(� �Uc:c��L19� 7o a�l ( Vo�.S �.�-+-��c]o�� <br /> TENANTNAME CONTACTFORPERMIT PHONE <br /> � 6�-m�� �ma <br /> CONTRACTOR ADDRESS 21P CONTR.LICENSE N <br /> PHONE n\ /� <br /> 1V <br /> PROPOSED USE OF BUILDING Building Mechanical Addi�on HEAT SOURCE <br /> PERMIT RL1 Combination RI.1 Plumbing WORK RL1 fUteration [� Electnc <br /> S ( � TYPE �,j Demolilion I, Sign TYPE �j New I u Gas <br /> �\e �.�r�� Q��� U Sprinkler l� RepaidMainL L� Otner <br /> CONTRACT PRICE OF WOR f C��C U CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> WORK DESCRIPTION \ \ \ <br /> R��;c tiec_}1�ct' U'aw.c..cJ�. Lov.ue:� w�`�;�rs �D�J<sr,�- ����ttt� <br /> �(.1t7��1 Il�w Sc-:� '��.i`Y�cGC . <br /> U <br /> PLUMBING M��'MANICAL <br /> N0. TYPE OF FIXNRE OR ITEM NO. TYPE OF FlXTURE OR IIEM <br /> Z WATER CLOSET(TOILET) A/C-A/HANDLING UNITS <br /> � BATHTUB � FORCED AIR SYSTEMS <br /> � �VATORY(WASH BASIN) HERT PUMP <br /> SHOWER UMIT HEATERS <br /> KITCHEN SINK&DISPOSAL CLOTHES DRYER <br /> DISHWASHER RANGE HOOD <br /> LAUNDRY TRAY WATER HEATER <br /> CLOTHES WASHER METAL FIREPLACE/STOVE <br /> URINAL FIREPLACE INSERT <br /> = DRINKING FOUNTAIN � GAS FIREPLACE <br /> FLOOR DRAIN GAS R4NGE <br /> _ BACKF�OW PREVENTER GAS PIPING <br /> _ SINK(SERVICE/BAR/MOP/ETC.) � EXHAUST FAN <br /> OTHER OTHER <br /> II HEREBY CERITIFY THAT I HAVE READ AND EXAMINED THIS APP�ICATION AND KNOW THE SAME TO 8E TRUE AND CORRECT. ALL <br /> I °ROVISIONS OF LAWS AND ORIDINACES GOVERIJING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETNER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT UOES N(1T PRESUh1E TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br /> STATE OR LOCAL I.AW REGI�LATINO�ONSTRli�TIaN OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br /> Ob'JNER OF THIS PROPERTY TO PERFOBM-7F7�WORK FOR WHICN APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACT�RS LAW 1t3. 7 CIiY AryD'�96.200 WAC. <br /> ./:�% <br /> � ��,..� r'�=_ ��3�`� <br /> Signature o Own'C�/ ontractodAuthonzed Agent / Oate <br /> � <br /> DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />