Laserfiche WebLink
� ' P��RMIT APPLICATII,N <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 99201 <br /> 425-257-8810— FAX 425-257-8857 <br /> SITE ADDRESS PARCEL TAX I.D.N PERMfT� I <br /> �Sla� Cc�aO <br /> LEGA LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDHESS ZIP PHONE <br /> TENANTNAME �� I CONTACTNAME PMONE <br /> CONTRACTOA ADDRESS �P CONTH.UCENSE• <br /> PMONE <br /> PROPOSED USE OF BUILDING I Building I"1 Mechanical Addition MEAT SOUHCE <br /> PERMIT RI..( Combinetion H Plumbing WORK Alleration R Eleccrk <br /> TYPE �..J Demolilion Ll Sign PE New ' L] Gas <br /> L� Sprinkler apair L� othsr <br /> CONTRACT PRICE OF WORK CITV R L AL$ TAX CODE 18�106 <br /> WORKDESCRIPTION (� `, <br /> O � � 1� ��� <br /> v � <br /> PLUMBING MECHAN AL � <br /> NO. TYPE OF FlJ(TUHE OR REM NO. PE O Fl%TURE OR ITEM , <br /> i <br /> = WATERCLOSET NC—AlHANDLINGUNITS ` <br /> BATHTUB FORCED AIR SYSTEMS 4J� <br /> LAVATORY(WASH BASIN) HEAT PUMP B �� <br /> = SHOWER � � UNIT HEATERS \ �iv � <br /> KITCHEN SINK 8 DISPOSAL CLOTHES DRYER QV <br /> � _ DISHWASHER n RANGE HOOD r�O V ` <br /> i = LAUNDRY TRAY \ N = WATER HEATER � � Q) <br /> CLOTHES WASHEF U METAL FIREPLACE/STOVE f <br /> I _ URINAL _ FIREPLACE INSERT (�9 <br /> DRINKING FOUNTAIN _ OAS FIREPLACE '�/ <br /> FLOOR DRAIN GAS RANGE <br /> � BACKFLOW PREVENTER GAS PIPING <br /> � _ SINK(SERVICE/BAR/MOP/ETC.) � EXHAUST FAN <br /> _ OTHER _ OTHER <br /> I <br /> � I HEREBY CERITIFY'HAT t NAVE FEAD AND EXAMINED THIS APPUCATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br /> PROVISIONS OF LaWS AND ORIDINACES GOVERNING THIS NPE OF WORN 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 LOCAI LAW REGULATING CONSTRUCTION OR T1iE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTMORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITM THE STATE <br /> CONTRACTORS LAW�827 RCW AND 296.200 WAC. <br /> SignaNre of OwnerlContractor/Authonzed Agent ate /� , <br /> i !�J <br />