Laserfiche WebLink
�ERMIT APPLICAT�N <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> �l'15-25?-8810- FAX 425-257-8857 <br /> SITE ADDRESS PARCEL TAX I.D.A I PERMIT p <br /> ''y:� � �- /it �.�., �-r. ,5l Po 3 05- oc,� <br /> LEGAL • LOT NO. BLOCK TRACT <br /> DESC. `� <br /> OWNER ADORESS 21P PHONE <br /> n ��I� �, � �: � n %�.: c n v <br /> .� T-=i `.T c . ti7Y Jrt%i'J / h � � � -`� J-.3��-//i� <br /> TENANT NAME I CONTACT FOR PERMIT PHONE <br /> CONTRACTOR AOORESS ZIP CONTR. LICENSE p <br /> PHONE <br /> PROPOSED USE OF BUILDING I Building fl Mechanical Addltlon HEAi SOURCE <br /> PERMIT � Com6ination �_� Plumbing IWORK R Altera:ion r, ElecUic <br /> TYPE DPmolilion LJ Sign TYPE � Na� g Gas <br /> S rinkler Re air/Malnl. Other <br /> CONTRACT PRICE OF WORK CITY OF EVERETT LOCAL SALES TA%CODE IS 7705 <br /> WORK DESCRIPTION . <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> _ WATER CLOSET(TOILET) A/C-A/HANDLING UNITS <br /> BATHTUB FORCED AIR SYSTEMS <br /> LAVATORY(WASH BASIN) HEAT PUMP <br /> _ SHOWER UNIT HEATERS <br /> KITCHEN SINK R DISPOSAL CLOTHES DRYER � <br /> DISHWASHER PANGE HOOD <br /> LAI:NDRY TRAY WATER HEATER <br /> _ CLOTHES WASHER METAL FIREPLACE/STOVE <br /> URINAL FIREPLACE INSERT <br /> DRINKING FOUNTNIN GAS FIREPLACE <br /> FLOOR DRAIN GAS RANGE <br /> BACKFLOW PREVEN7ER GAS PIPING <br /> SINK(SERVICE/BAR/MOP/ETC.) EXHAUST FAN <br /> OTHER OTHER <br /> I HEREBV CERITIFV THAT I HAVE REA�AND E.YAMINED THIS APPUCATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br /> PROVISIONS OF�LAWS AND ORIOINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT THE GRANTING OF A PERNIT 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 BV�fHE <br /> OWNER OF TNIS PROPERTV TO PERFORAI THE WORK FOR WHICH APPLICATION IS MADE AND 1 COMPLY WITH THE STATE <br /> CONTRACTORS LAW 1827 RCW AND 296200 WAC <br /> / ;_, <br /> ���i� �� i � %i_�ij.. <br /> I ignature of wneNCon�ractonAulhorized Agent Dale <br /> I_-_ <br /> DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />