Laserfiche WebLink
PL'��MIT APPLICATI�� <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEQAR STREET, EVERETT, WA 98201 <br /> 425-257-8810- FAX 425-257-8857 <br /> SITE ADDRESS PARCEL TAX I.D.A PERMiT a <br /> 4 �i VC� �RKL fl . o 00 oc� <br /> LEGA LOTNO. BLOCK THACT <br /> DESC. <br /> OWNER ADORESS ZIP pHONE <br /> p,�N rWcn��y sr�t� �ao31 �,arc��,-Tr 4z� . �o;Hcl� �Ko�L ��.�)b7o-`�S <br /> TENANTNAME I CONTA:TNAME PHONE <br /> CONTRACTOR AODRESS ZIP CONTR.LICENSE'1 <br /> PHONE <br /> PROPOSED USE OF BUILDING Building Mechanical AOdiiicn MEAT SOURCE <br /> PERMIT Combinalion R�( Plumbing WORK Allerelion Q Electric <br /> S�� TYPE � Demolilion u Sign IYPE � New I �] Ges <br /> U Sprinkler Re�air/Mainl. L� Olher <br /> CONTRACT PRICE OF WORK �f—��� /cG�O CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> cT J <br /> WORKDESCRIPTION Npw CQJf.feCJ <br /> ��-t�7 <br /> � <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF flKfURE OR ITEM N0. TYPE OF flXTURE OR ITEM <br /> WATER CLOSET A/C—AlHANDLING UNITS <br /> � _ BATHTUB _ FORCED AIF SYSTEMS <br /> I _ LAVATORY (WASH BASIN) HEAT PUMP <br /> _ SHOWER UNITHEATERS <br /> KITCHEN SINK 8 UISPOSAL _ CLOTHFS DRYER <br /> DISHWA3!:'.� _ RANGEHOOD <br /> LAUNDF,i l RNY WATER HEATER <br /> CLOTHES WASHER METAL FIREPLACE/STOVE <br /> URINAL FIREPLACE INSERT <br /> DRINKING FOUNTAIN C,AS F�REPIACE <br /> FLOOR DRAIN GAS RANGE <br /> _ OACKFLOW PREVENTER _ GAS PIPING <br /> SINK(SER'.�CE/8AR/MOP/ETC.) _ EXHAUST FAN <br /> OTHEP_ OTHER <br /> I HEREBV CERI7IPY'HAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND COFRECT. .4LL <br /> PROVISIONS OF L1WS AND ORIDINACES GOVERNING THIS TVPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GFANTING OF A PERMI?�OES N07 PRESUME TO GIVE AUTHORITY TO VIOL4TE OR CANCEL THE PROVISION OF AN`.'OTHER <br /> STATE OR LOC.1L LA`N REGULA7ING CQNSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORI2ED BY THE <br />- OWNE9 GF THIS PROPERN TO PERFORtd THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> COPJTRACTORS LAW 1827 RCW AND 296.200 WAC. <br /> ;��ti r��ci�r�w� 7- a 6 - a�2 � <br /> Sgnature ol 0lvner/Conlractor/Authonzed Agenl Date <br /> � <br />