Laserfiche WebLink
PLAMIT APPLICATICA <br />4W77 CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 <br />SITE ADDRESS sj <br />PARCEL TAX I.D. # PERMIT r <br />--, <br />A001 %y s,E (3oaod-o3 3 <br />LEGA LOT NO. I BLOCK TRACT - <br />�iRi c qj/c v Ta ago 7ys6 gpoo- PHONE <br />TENANT NAME CONTACT NAME <br />CONTRACTOR ��� ADDRE9E ZIP CONTR. LICENSE M <br />PHONE <br />PROPOSED USE O^BUILDING <br />Buildln g <br />Combination <br />Mechanical <br />Plum6mg WORK4Addilion <br />Alteration <br />HEAT SOURCE <br />Electnc <br />I{�-�{( <br />PERMIT <br />� <br />I <br />Demolilion <br />I-( <br />fJ <br />Sign TYPL New <br />Gas <br />JL�1"'�� <br />TYPE <br />Repair/Moral <br />U Olher <br />�,1 <br />�oy r ''csl �1` <br />Sprinkler <br />CITY OF EVERETT LOCAL SALES TAX <br />CODE IS 3105 <br />CONTRACT PRICE OF WORK <br />WORK DESCRIPTION / f`,,116 INO- /0J 3 /N �A �r:S T i �1 r /Z %O(/N O/l <br />NO. I TYPE OF FIXTURE OR ITEM <br />_ WATER CLOSET <br />_ BATHTUB <br />_ LAVATORY (WASH BASIN) <br />_ SHOWER <br />_ KITCHEN SINK & DISPOSAL <br />_ DISHWASHER <br />_ LAUNDRY TRAY <br />_ CLOTHES WASHER <br />_ URINAL <br />_ DRINKING FOUNTAIN <br />FLOOR DRAIN <br />_ BACKFLOW PREVENTER <br />_ SINK (SERVICE/BAR/MOPiETC.) <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 />RANCE 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 REAL ANf' 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 WHET IER SPECIFIED HEREIN OR <br />SNOT THE RANTNG OF A PERIT DOES TATE OR LOCAL ILAW REGULATING CONSTO UCTION OR THE PERFORMANCE OF CONSTRUCTION OTHAT AM AUTHORIZED BY R CANCEL THE PROVISION OF ANY0 ER <br />E <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOn WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br />