Laserfiche WebLink
PERIVIIT pPPLICATI�ON <br /> CITY OF EVERETT PERMIT SERVICES <br /> 5200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810— FAX 425-257-8857 <br /> I _ � —/o—O� <br /> SITE ADDRESS , �- PARCEL TAX I.D.# PERMITK <br /> �IOZS � II�H-, �� �. I�L� L� I�i't�1� "7y`-; �G'DCi��C% �.[>C:C; �, /-' ',% ,'�` --c';` <br /> LEGAL LOTNO. ELOCK TRACT <br /> DESC. <br /> OWNER ADDRESS ZIP PHONE <br /> �1=�n,' �I - KI� � ��� <br /> TENANT NAME CON'(ACT FOR PERMIT PHONE <br /> CONTRACTOR ADDRESS ZIP CONTR.LICENSE k <br /> / � <br /> �.urzr:;_ �/Omc� /7L-fl/:rtf ,-�il� l4`ll�` I�I'C'tYi• -��,�l�.�c�. 'OCY%lily, %l� %,�0/L cjC�TTcH/f/i�.l � <br /> PHONE - . C-I -n � <br /> �{7 �� y �� . CJ7. �� <br /> I PFOPOSED USE OF BUILDIN6 � Building � Mechanical AUtlilion HEAT SOURCE <br /> PERMIT Combinalion Plumbing WORK iR�( P.Ileration Electric <br /> ,I TYPE Demolilion Sign TYPE �.] Nrw � Gas <br /> Sprinkler U pair/MaiN. Oih=r <br /> CONTRACT PRICE OF WORK �j 'J �_� ��/:, (i(:� CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> WORKDESCRIPT�D�J ' — �_�:�('�� c <br /> j?Iu�����V� irl� c�i� `ED C7�n�Y� 'i I it5;���Li_C �7b� �"/L� �;�1�-lY�(� c�-�� � � <br /> �,ti� � � <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXT�RE OR ITEM <br /> VVATER CLOSET A/C-AIHANULING UNITS <br /> BATHTUB FORCED AIR SYSTEI✓1S <br /> LAVATORY(WASH BASIN) _ HEAT PUMP <br /> SHOWER UNIT HEATERS <br /> KITCHEN SINK 8 DISPOSAL CL07HES DRYER <br /> DISHWASHER RANGE HOOD <br /> LAUNDRY TRAY WATER HEATER <br /> CLOTHES WASHER hIETAL 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 />� 0'f'.ER � OTHER "i'C�: `c�Cl�?LLii���_ <br />� — �P �7� C- ST�c <br /> I <br /> I HEREBY CERITIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CC�RRFCT. ALL <br /> PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHFTHER SPECIFiED HEREIN OR <br /> NOT. THE GRANTING OF A PERMiT DOES NOT PRE�UME 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 APd AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORfd THE WORK FOR WHICH APPLICATION IS MADE AND 1 COMPLY NJIThI l"HE STATE <br /> CONTRAGTQRS LAW 18.2�CW AND 29ti.200 WAC. <br /> �I � � � � � <br /> � �...�tl��.�(�ril � ' ' /v��-t/Y � - /b -D� <br /> SignaWre of OwnedContractor uthor¢ed Agent Date <br /> DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />