Laserfiche WebLink
_ ; - <br /> � P�RMIT APPLICATIC►N <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAH STREET, EVERETT, �NA 98201 <br /> 425-257-8810- FAX 425-257-8857 <br /> SITE ADDRESS PARCEL TAX I.D.N P,{�[RMIT tt <br /> �417 /� � �r� S� �✓€e�.CT' d�7 bomo�oZ oo I� D �� <br /> LEGAL LOT NO. BLOCK TRACT <br /> DESC. I <br /> OWNER ADURESS PHONE <br /> ��uend'/ �,1� AN�✓ S l�7" R. :� , F�� fLR77 � ')��7 — 9�0/ <br /> TENANT Nl�ME � �— i CONI'ACT NAME � PHONE <br /> �-- `��E�(9zs�3��9��� <br /> CON7RACTOR I ADGRESS I CONTR.LICENSE A <br /> PHONE � <br /> � <br /> PROPOSED USE OF BUILDING � Building � Mochanical nddition HEAT:�URCE <br /> PERMIT Combination Plumbing WORK � queration Q eiectric <br /> TYPE Demolilion Sign TYPE � u Ncw U Gas <br /> v QC S Sprinkler U RepaidMainl. U O!her <br /> ��JNTRACT PRICE OF WORK CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> WORK DESCRIPTION <br /> I'L X 1 G� <br /> PLUMBING MECHANICAL <br /> NO. TYpE OF FIY.TURE OR ITEM N0. TYPE OF FIXTURE OR ITEM <br /> _ WATER CLOSET _ A/C-A/HANDLING UNITS <br /> _ BATHTUB _ FORCED AIR SYSTEMS <br /> _ LAVATORY(WASH BASIN) _ HEAT PUMP <br /> _ SHOWER _ UNIT hl[ATERS <br /> _ KITCHEN SINK& DISPOSAL _ CLOTHES D9YER <br /> _ DISHWASHER _ RANGE HOOD <br /> _ LAUNDRYTRAY _ WATER HEATER <br /> _ CLOTHES WASHER _ METAL FIREPLACE/STOVE <br /> _ URINAL _ FIREPLACE INSERT <br /> _ DRINK;NG:OUNTAIN _ GASFIREPLACE <br /> _ FLOOR DRAIN _ C,AS RANGE <br /> _ BACKFLOW PREVENTER _ GAS PIPING <br /> _ SINK(SERVICE/BAR/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 TfiUE 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 PRESUM[TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br /> STATE OR LOCAL LAW REGULATING CONSTAUCTION OH THE PERFORMANC�OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK fOR WHICH APPLICATION IS P..7ADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br /> �`+�'vl" V`"�l�� � � �sL Z_w� c�" � � <br /> Signature of(pwnedContractor/AulHorized Agenl � p'—a�e— t/ <br />�'----____ ---- — <br />