Laserfiche WebLink
PeRMIT APPLICATIOnI <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET. EVERETT, WA 98201 <br /> 425-257-8810- FAX 425-257-8857 <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT# <br /> � so 4 sou � � �-�, � m oyos-�Z2 <br /> IEGA LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRESS ZIP PHONE <br /> Jo� r v � �� n �elfi,t� 4�dU .So� �,�1 ,4� &�. 9�z� y�-� - <br /> 3 355 -/7S � <br /> TENANTNAME I CONTACTFORPERMR PHONE <br /> CONTRACTOR ADDRESS 21P CONTR.LICENSE M <br /> PHONE n��� <br /> �� <br /> PROPOSED USE OF BUILUING I Building fl Mechanical Addition HEAT SOURCE <br /> PERMIT R Combination �-� Plumbing IWORK R AlteraUon � Electric <br /> TYPE D Demolition U Sign 7'YFE � New I Gas <br /> �� U Sprinkler RepaiNMaint. Other <br /> CONTRACT PRICE OF WORK CITV OF EVERETT LOCAL SALES TA7C CODE IS 3105 <br /> WORK DESCRIPTION � <br /> �ilG�--- l�� - �c__ <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXiURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> _ WATER CLOSET(TOILET) AIC–A/HANDLING UNITS <br /> _ BATHTUB FORCED AIR SYSTEMS <br /> _ LAVATORY(WASH BASIN) HEAT PUMP <br /> SHOW ER UNIT HEATERS <br /> _ KITCHEN SINK 8�ISPOSAL 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 /> = BACKFLOW PREVENTER — GAS PIPING I <br /> _ SINK(SERVICE/BAR/MOP/ETC.) EXHAUST FAN <br /> OTHER OTHER <br /> I HEREBY CERITIFV'i HAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW TFiE SAME TO BE TRUE AND CORRECT. ALL <br /> PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TYPE OF WORK 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 TNE PROVISION OF ANY OTHER <br /> STATE OR LOCAL LAW REGULATING CONSTRUC710N OR TFiE PERFORMANCE OF CONSTRUCTION. THAT 1 AM AUTHORIZED BY THE <br /> OWNER F THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> C TR TORS LAW 1 .27 RCW AND 29f�. 00 WAC. <br /> w�(.�-.J '�X S "�d'- ��l <br /> ign ture of OwnedContract /Authonze0 Agent Date <br /> DEBIT& CREDIT CARDS ARE NOT ACCEPTED <br />