Laserfiche WebLink
—� ; <br /> �ERMIT APPLICATION <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 n <br /> O !,V l�T7' <br /> LEGA LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRESS ZIP PHONE <br /> G l�'`( OF EtJi��TT 2000 !-f��w� -rrA-v� r'!S� 1 � 677sGi <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> C. L�'y TG►M 200dyGt <<�"'7 7w} <br /> � Jas P i2 irrl.w �rt1TB�m�c ��.t'��_4����_ <br /> CONTRACTOR H�y��R JJ S Q � �DRESS ��y( 1 N D fFJ�'(V ZIP CONTR.LICENSE K <br /> KB�v r w �+- 9fCo3 2 <br /> PHONE ! .�'�.-��–•-j� <br /> '..,� i �'7 t-" 47r�a <br /> PROPOSED USE OF BUILDING I7 Building f� Mechanical fl AtldiUon I HEAT SOURCE <br /> G. O �r,���L��K/��� PERMIT K Combination iq Plumbing WORK K Alleretion p eiearie <br /> TYPE �.� Demolition V Sign TYPE �...1 New � Gas <br /> C,�N�-�YL. i� Sprinkler LJ RepairlMaint. U Other <br /> CONTRACT PRICE OF WORK -/��' CITY OF EVERETT LOCAL SAlE4 TA)C CODE I$J105 <br /> WORK DESCRIPTION <br /> /,I.rU,JtJ-�e se.f!-�8 f� ►va kau.� ef iN �'��Q r�vG s=o� <br /> C L T f/ K l. TC t F is-ilJ �►v�l 2�L$T R�b�, o � �� i2,5 T ��� <br /> PLUMBING MECHANICAL <br /> Np. TYPE OF FIXTURE OR ITEM NO. TYPE OF FI%TURE OR IiEM <br /> WATER CLOSET(TOILET) _ AIC–AIHANDLING UNITS <br /> BATHTUB FORCED AIR SYSTEMS <br /> � LAVATORY(WASH BASIN) _ HEAT PUMP <br /> SHOWER _ UNITHEATERS <br /> 3� KITCHEN SINK 8 DISPOSAL _ 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 DR41N _ GAS R4NGE <br /> BACKFLOW PREVENTER GAS PIPING <br /> '� SINK(SERVICEIBARlMOP/ETC.) _ EXHAUST FAN <br /> OTHER OTHER <br /> � f'%LOb/L. S�N KS — <br /> I HEREBY CERITIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE 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 GR4NTING OF A PERMIT DOES NOT PRESUAIE TO GIVE AUTHQ.2ITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br /> STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE�ER�'�13MAiJCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br /> OW NER OF THIS PROPERTY TO PERFOR41 THE WORK FOR WHICH.1PPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTOR 1AW 18.27 RCV�ND 6.200 WAC. <br /> � /�/f��'.�,�, �eo3 <br /> Signature of Owner/GTun rectodAulhonzed Agent Date <br /> DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />