Laserfiche WebLink
♦ <br /> P 'RMIT APPLICATIGN <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810- FAX 425-257-8857 <br /> b - 3 -o3 <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT# <br /> �30 I � ' o C v - Oo57/ 70090090 .3b� �oa <br /> LEGAL LOTNO. BLOCK TRAC <br /> oesa / 0 (�O� D-0Z � 0 F cl�ES (-� D'i 1�oA( <br /> OWNER AUDRESS ZIP PHONE <br /> �ARRY �,� NeRi 5cN qS203 C�✓u�3S�3SqJr <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> ,�/ f�NF D��N�� <br /> CONTRACTOR ADDRESS ZIP CONTR.LICEN5EN <br /> PHONE j)��n� <br /> PROPOSED U OF BUILDING Building � Mechanical I Addition HEAT SOURCE <br /> PERMIT R Combinalion Plumbing WORK R Alleration � ElecUic <br /> TYPE D Demolition Sign TYPE D New Gas <br /> U Sprink�er I U RepairlMaint. Other <br /> CONrRACT PRICE OF WORK ���� CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> WORK DESCRIPTION <br /> �F p�a�e ,L.Xi s;r.v�, ��cK 5,30 '� S,� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FI%TURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> WATER CLOSET(TOILET) A/C—A/HANOLING UNITS <br /> BATHTUB FORCED AIR SYSTEMS <br /> LAVATORY(WASH BASIN) HEAT PUMP <br /> SHOWER UNIT HEATERS <br /> KITCHEN SINK 8 DISPOSAL CLOTHES DRYER <br /> DISHWASHER RANGE HOOD <br /> LAUNDRY'fRAY WATER HEATER <br /> CLOTHES WASHER METAL FIREPLACE/STOVE <br /> URINAL FIREPLACE INSERT <br /> DRINKING FOUNTAIN GAS FIREPLACE <br /> FLOOR DRAIN GAS RANGE <br /> BACKFLOW PREVENTER GAS PIPING <br /> SINK(S[RVICE/BAR/MOP/ETC.) EXHAUST FAN <br /> OTHER OTHER <br /> I I HEREBY CERITIFY THAT I HAVE READ AND EXAh11NED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br /> i PROVISIONS OF IAWS AND ORIOINACES GOVGRNING THIS TVPE OF WORK WILL BE COMPUED WITH WHETHER SPECIPIED HEREIN OR <br /> I ^'OT. THE GRANTING OF A PERMIi DOES NOT PRESUAIE TO GIVE AUTHORIN TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br /> STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHOR12E0 BY THE <br /> OWNER O THIS PROPERTY TO PERFORA4 THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRA�j�RS LAW JB.2�AND 296.200 WAC. <br /> /� � <br /> '`, `c� s - � 03 <br /> Signature OwnedContr ctor/Authonzed Agent te <br /> DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED (I� <br />