Laserfiche WebLink
P�RMIT APPLICATiON <br /> CITY OF EVERETT PERMIT SER'VICES <br /> 3200 CEDAR STREET, EVERETT, WA 9?201 <br /> 425-257-8810-FAX 425-257-8857 <br /> SITE ADDRESS • PARCEL TAX I.D.� PERMIT# <br /> 32ot S�nra--I A.� ko d�-c <br /> IEGA LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER �u�E� ����.ty���RESS ZIP PHONE <br /> G�-�`'r a� C--v�ZG--i'r 3� o� CC-DcfL ST °I82�� <br /> 7ENANT NAME �r CONTACT FOR PERMIT PHONE <br /> �(�az��zc E - -�1��I Ja� ���' �as 335-4c�4s <br /> CO TRACTOR • ADDRESS ZIP CONTR.LICENSE• <br /> �'�`��`' �'� ��� 231 I 153� A�� A�.�n' <br /> PHONE � �`oy�����' <br /> 42S 335�4(�5 SNc�..lc�i5.-1 l�✓/�- <br /> PROPOSED USE OF BUILDING I P�E�T u CPm kliGon n U Sign bingal �E �../ Repaitl/Maint. HEALI 0 he�r c <br /> CJ�Z-� �f'�cG �� I U I <br /> CONTRACT PRICE OF WOR 7��y� �� CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> ( J <br /> WORK DESCRIPTION <br /> �c.�r'� �vCe SPR�N�c��2 �-�'�-DS r�� <br /> N� T�n-►�� �n �� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTUR�'OR ITEM • <br /> _ WATER CLOSET(TOILET) A/C—AIHANDLING UNITS <br /> BATHTUB FORCED AIR SYSTEMS <br /> LAVATORY(WASH BASIN) HEAT PUMP <br /> SHOWER UNIT HEATERS <br /> KITCHEN SINK&DISPOSAL CLOTHES DFiYER <br /> DISHWASHER � RANGE HOOD <br /> LAUNDRYTRAY 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(SERVICE/BAR/MOPiETC.) EXHAUST FAN � y� <br /> OTHER OTHER W <br /> I HEREBY CERITIF THAT I HAVE FtEAD AND EXA ED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br /> PROVISIONS nF WS AND ORIDINAC GOVE ING THIS TYPE OF WORK WILL BE COMPLIED W 7H WHETHER SPECIFIED HEREIN OR <br /> N07. THE GRA ING OF A PERMIT S NO RESUA1E TO GIVE AUTHORITY TO VIOLATE OR CAVCEL TME PROVISION OF ANY OTHER <br /> STATE OR LO LAW REGUTAT ONS CTION OR THE PERFORMANCE OF CONSTRUCTION. THAT 1 AM AUTHORIZED BV THE <br /> WNER OF T PROPERN T . OR HE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITFi THE STATE <br /> JNTRACT LAW 18.27 R � D 29 . 00 WAC. �� �/ <br /> Signatu of OwnedC tracror/A onzed Agent Date <br /> 1� <br /> DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />