Laserfiche WebLink
�-ERMIT APPLICAT�JN <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810-FAX 425-257-8857 <br /> a2 ^ /D ES ',/� G'OCPAR�LTAXI.D.Na X��A�_�/ <br /> r.r !�/ .S(/ <br /> LEGA LOTNO. BLOCK TRACT n <br /> DESC. �p t �O�� `� <br /> OWNER A�DRESS ZIP PHONE <br /> �j TllE�,1' /06/� /,Q�f'�� f�v� if/� ��i,fro.t� p� <br /> TENANTNAME CONTACTNAME PHONE <br /> 20�- 7P6 1f�l.f <br /> CQNTRACTOR � J ADORESS f� ZIP CONTq.LICENSE� <br /> p62 (/e��,p�/� V,P2�('`'`�P /I.ZOS` �E �� � 9�04� OL�FN�'*�//Gi!/ <br /> PFiONE 2 �a�--��y-��i.� B��i�`��, �,� <br /> PROPOSED USE OP BUILDING � Building � Mechanical I �Addition I HEAT SOURCE <br /> PERMIT Combinalion Plumbing WORK Alteration �Eiectric <br /> / TYPE Demolition Sign TYPE New Ges <br /> ^�r/• /G� T-i¢ / Sprinklef FiepaidMeint Other <br /> ! QI / <br /> CONTRACT PRICE OF WORK I CITY OF EVERETT LOCAL SALES TA%COUE IS 3105 <br /> WORK DESCRIP ON M� �rh ,x G �X�J y- � �� � `�� �. d��� <br /> u��r�c�� � O�d � / � a <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM N0. TYPE OF FlXTURE OR REM <br /> WATER CLOSET A/C—A/HANDLING UNITS <br /> BATHTUB FORCED AIR SYSTEMS <br /> LAVATORY(WASH BASIN) HEAT PUMP <br /> SHOWER UNIT HEATERS <br /> KITCHEN SINK&D�SPOSAL 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 RANGE <br /> BACiCFLOW PREVENTER GAS PIPING j <br /> S1NK(SERVICE/BAR/MOP/ETC.) � EXHAUST FAN <br /> OTHER OTHER <br /> I HEREBY CERITIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE ANO CORRECT. ALL <br /> PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS 1YPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRE:SUME TO GIVE AUTHORITY TG VIOLATE OR CANCEL THE PROVISION OF ANY OTHER � <br /> STATE OR LOCAL LAW FEGUTATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHOR12ED 9Y THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY INITH THE STATE <br /> CON ACTORS LAW 1�27 RCW AND 256200 WAG , <br /> � ��7/�.� <br /> Signawre of Owner/Contractod honzed Agent �Date <br /> DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />