Laserfiche WebLink
� <br /> P�RMIT APPL�ICATIUN <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.tf PERMI7 k <br /> d► S�� �1-� o0 9sc� 6 C -o ; <br /> LEGAL LOTNO. BLOCK TRACT � I <br /> DESC. � '� -�y <br /> OWNER ADDRESS ZIP PHONE <br /> �,�� � A��,�� l��r a�9 �B`� �t. �v 9s�� �5- ass-i , d <br /> TE ANT NAME CONTACT FOR PERMIT PHONE <br /> ��rl.i .� yaS+��O '�1 /V <br /> CONTRACTOR n'^O�� AODRESS ZIP CONTR.LICENSE# <br /> 1�J <br /> PHONE <br /> PROPOSED �OF BUILI�NG Building I� MeChanical Addition I HEAT SOURCE <br /> ' C 1 � PERMIT RI--( Combination �-� Plumbing WORK Alteration �f�-L ElecVic <br /> 1 � 7 7YPE �j Demolition LI Sign IYPE New �q Gas <br /> ' SY��'��!��� U Sprinkler Repair/Maint. . L� Olher <br /> CONTRACT PRICE OF WORK CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> WORK DESCRIPTION / ���`�.,� ' <br /> �' �- <br /> �'1� ���J ,�, ����., , c�-���G-� ����r- 2�/23 � <br /> > , <br /> PLUMBING MECH'NICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> WATER CLOSET(TOILET) A/C—,4�HANDLING UNITS <br /> BATHTUB FORCED AIR SYSTEMS <br /> LAVATORY(WASH BASIN) HEAT PUMP <br /> SHOWER UNIT HEATERS <br /> KITCHEN SINK&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 DRAIN GAS RANGE <br /> BACKFLOW PREVENTER GAS PIPING <br /> SINK(SERVICE/BAR/MOP/ETC.} EXHAUST FAN <br /> OTHER OTHER <br /> I HEREBY CERITIFY THAT I HA`/E READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br /> PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS.T'PE OF WORK WILL BE COMPLIED WITH WHE�HER SPECIFIED HEREIN OR <br /> NOT. THE GRANTIPJG OF A PERMI7 DOES NOT PRESUME 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 VJHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS U1W�8.27 RCW AND 296.200 WAC. <br /> —� �✓� �'�_ /� Srb-�- a <br /> Si ature of wnedContractor/Authonzed Agent a e�� '3 i� <br /> DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />