Laserfiche WebLink
P�RMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES 03?� <br /> 3200 CEDAR STREET, EVERETT, WA 98201 r ,p.�� <br /> 425-257-8810- FAX 425-257-8857 I� ��f� <br /> Ci <br /> SITE ADDRESS, �� e �OpARCEL TAX I.D.# PERMIT# <br /> r�n. gL��c�9Da � ��5�oa - a� <br /> LEGA LOTNO. BLOCK TRACT <br /> DESC. #k <br /> OWNER ADDRESS ZIP PHONE <br /> �1�e v e n sc�ss� J D3� �1 g`�" pL Sc� �r�/ ya.s��3� <br /> TENANTNAME CONTAC7FORPERMIT PHONE <br /> _ � �tQ u�, G r YYI�.Yu �e s�o t/�5,303 '13�� <br /> CONTRACTOR��� �ar� �� �h�� �b�� �L S� Z�p CONTR.LICENSE# <br /> PHONE , /�S !�� —'I J l � liU �re re �t w�- q 8�3 <br /> �a <br /> PROPOSED USE OF BUILDING riX Building I� Mechanical Additlon fiEAT SOURCE <br /> PERMIT K Combination �_� Plumbing WORK AlteraUon ElecVic <br /> TYPE �� Demolition �� Sign TYPE New Gas <br /> LJ Sprinkler RepairlMaint. Other <br /> CONTRACT PRICE OF WORK CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> WORKDESCRIPTION �� � Q�� � �.%O� �-/ ��.��Q� <br /> CQCU�-f�DY" vt�(./h`l'Q'(.� .�-O�L�-✓ �,'�Q.i? "Q <br /> CL� CLw1 �,Qi��iSf71't�.�IC�.Cl�CQ, . <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> WATER CLOSET(TOILET) C� A/C—A/HANDLING UNITS <br /> BATHTUB �.� FORCED AIR SYSTEMS'• / <br /> LAVATORY(WASH BASIN) HEAT PUMP p J, ,CJ� <br /> SHOWER � UNIT HEATERS ���p,�vt� 09.� —1' <br /> KITCHEN SINK&DISPOSAL CLOTHES DRYER <br /> DISHWASHER � RANGE HOOD <br /> i LAUNDRY TR.4Y WATER HEATER <br /> � CLOTHES WASHER METAL FIREPLACE/STOVE <br /> URINAL FIREPLACE INSERT <br /> � DRINKING FOUNTAIN GAS FIREPLACE <br /> �G FLOOR DRAIN GAS R,4NGE <br /> cT BACKFLOW PREVENTER GAS PIPING <br /> C SINK(SERVICE/8AR/MOP/ETC.) � EXHAUST FAN <br /> OTHER OTHER <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 GRANTING OF A PERMIT 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 PROPE TY TU PERFORM THE WORK FOR WHICH APPLICATION IS MAOE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 1 7 RCW ND 296.200 WAC. <br /> -' � V <br /> r <br /> Signature o wner/Contra or/Authorized Agent Date <br /> DEBIT& CREDIT CARDS ARE NOT ACCEPTED <br />