Laserfiche WebLink
SITE ADDRESS �� �� �. <br />� <br />LEGA LOTNO. <br />DESC. <br />OWNER <br />����iCJ�� 7. <br />TENANTNAME <br />PERMIT APPLICATION <br />CITY (1F EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT', WA 98201 <br />425-257-8810 - FAX 425-257-8857 <br />���� PARCEL TAX I.D. X <br />� I '-1 ��, �' <br />BLOCK TRACT <br />ADURESS <br />w`(ATt 2��oS Sr�� ,� <br />ICONTACT FOR PERMIT <br />CONTRACTOR ��JA��� ��.�-�L/��°��S I ESC%`� LtL�`C <br />PHONE / yaS)�1 / S— S� ��- I�`'f N(,I.�C'C�7 <br />� `i <br />PROPOSED USE OF BUILDING <br />CONTRACT PRICE OF WORK <br />Building Mechanical <br />PERMIT Combination RL1 Plumbing <br />TYFe Demolition U Sign <br />Sprinkler <br />S • Ck.,� <br />PERMIT # <br />M o3,0 <br />�k�c�� c�C�(Y�S�$�� " �(� <br />PHONE <br />c�«�Yas)k�5 -��1 <br />� G ZIP CONTR. LICENSE k <br />C 4�U3�- AoVR��la33J� <br />Additlon NEATSOURCE <br />WORK � AlteraUon (7 E�ecaic <br />TYPE New D Gas <br />Repair/MainC �� Other <br />CITY OF EVERETT LOCAL SALES TAIf CODE IS �705 <br />WORKDESCRIPTION � N57 ✓��l( ��(}(��1 (� � �\ A-S ('��!'�-`[��`11�� .S�IU�� <br />I�C���iNl_ +�1STY�l�A1CN C� C�AS �'iP� <br />C� ►',s � l�1 � n� C.I�,2 C,'�S lv� � i�� �� S�ZN �. <br />NO. I TYPE OF FIXTURE OR ITEMi <br />_ WATER CLOSET (TOILET) <br />BA?HTUB <br />_ IAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 DISPOSAL <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKF�OW PREVENTER <br />_ SINK (SERVICE/�AR/MOP/ETC.) <br />OTHER <br />r--,�c�.�,. n�� �+� <br />NO. � TYPE OF FIXTURE OR ITEM <br />Fvc: - nINANDLi�G UNITS <br />FORCED AIR SYSTEMS <br />HE4TPUMP <br />UNIT HEATERS <br />CLOTHES DRYER <br />RANGE HOOD <br />WATER HEATER <br />METAL FIREPLACE/STOVE <br />�IREPLACEINSERT <br />GAS FIREPLaCE <br />GASRANGE <br />GAS PIPING <br />EXHAUSTFAN <br />OTHER <br />I HEREDV CERITIFV THAT I HAVE READ AND E.YAMINED THIS APPLICATION AND KNOW TI1E SAME TO BE TRUE AND CORRECT. ALL <br />PROVISION� OF L'r,WS AND ORIDINACeS GOVERNING THIS TYPE OF WORK WILI BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERM1IIT DOES NOT FRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br />STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE FND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 RCVV AND 296.200 WAC. <br />_ �L �-'� l�-� i I Ci �� � �[Y� <br />DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />