Laserfiche WebLink
ERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FF+X 425-257-8857 <br />SITE ADDRESS <br />l�on� l.sl- � 1� <br />LEGA LOTNO. <br />DES4 ✓9�q/�E � <br />OWNER <br />4iEV�NDE� S. <br />TENANTNAME <br />CONTRACTOR <br />PHONE <br />PROPOSED USE OF BUILDING <br />r���US� <br />PARCEL TAX I.D. # <br />�UP.�Gi'r (�o.> >�z Q U a(7� o � <br />BLOCK TRACT <br />AODRESS 21P <br />:u lao�3 ,�►iTA„s \l�l � �vFQ� � � <br />ICGNTACT FOR PERMIT <br />ADDRESS <br />Building D Mechanical <br />PERMI7 � Combination [� Plumbing <br />TYPE Dem0lition U Sign <br />Sprinkler <br />4,,� �i y�s� q g <br />'1 <br />PHONE <br />ZIP CONTR. LICENSE # <br />Adtlilion HEATSOURCE <br />WORK Alte2tion � Electric <br />TYPE New Gas <br />Repair/MainL . Other <br />CONTRACT PRICE OF WORK �/j7 ` Cil�i �' EVERETT L(�CAL SALES TAX CODE IS 3105 <br />w <br />W'TCK D�oUt N Ci� I(fi�� �M Il.uc `��2•L�.(� � . <br />0� <br />N0. I TYPE OF FIXTURE OR ITEM <br />WATER CLOSET (TOILET) <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK & DISPOSAL <br />DISHWASHER <br />LAUN�RYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTER <br />SINK (SERVICE/BAWMOP/ETC.) <br />OTHER <br />NO.. I TYPE OF FIXTURE OR ITEM <br />A/C — A/HANDLING UNITS <br />FORCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT HEATERS <br />CLOTHES DRYER <br />RANGE HOOD <br />WATER HEATER <br />METAL FIREPLACE/STOVE <br />FIREPLACE INSERT <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUSTFAN <br />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 COAIPLIED WITFi 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 O�? LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORI2ED BY THE <br />OWNER OF THIS PROPERTYJfj PERF)(2M THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTi3ACTORS LAW 18.27 fYCW1ANPI106.200 WAC. <br />DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />�a <br />