Laserfiche WebLink
ERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES �o� -07 <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425.257-8857 <br />SITE ADDRESS PARCEL TAX I.D. N PERMIT 0 <br />LEGAL LOT NO. BLOCK TRACT <br />DESC. <br />ZIP PHONE <br />OWNER ADDRESS <br />( ,1 Dl (�)�a-is.c <br />'L �ye'v ttLCe S 32U 1 DIp'=' MG SAC I CO w Uvy <br />TENANTNAME CONTACT FOR PERMIT PHONE <br />�Li" S{ Vevttwe � 1� Y�yct►T AC (2[ �328 328 <br />CONTRACTOR ADDRESS 27P CONTR. LICENSE <br />LtiSw) /) ALCU m , I(ic . I s3 S. JckCleCon S4 . <br />PHONE �814�" I�l.l{K}IIAIZZZC3 <br />PROPOSED USE OF BUILDING <br />ii Building D Mechanical <br />tlHK.t/ Combination u PlumWng <br />WORKAlterahon <br />ion <br />A,:;, <br />MEAT SOURCE <br />I] Electric <br />PERMIT <br />TYPE <br />tir O Sign <br />TYPE <br />B <br />1 <br />LIl u►1CrCIk( <br />Serinkleon <br />P <br />RepaulMaint. <br />Other <br />IF <br />CONTRACT PRICE OF WORK 5.35� <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />WORK DESCRIPTION I `v; t „ f1 h ; Yin t Lvr ►) J ayvve' S I V, slieu be S CU/14 <br />PLUMBING <br />NO. TYPE OF FIXTURE OR ITEM <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />WATER CLOSET <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 DISPOSAL <br />DISHWASHER <br />LAUNDRY TRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTER <br />SINK (SERVICEIBARIMOP/ETC) <br />OTHER <br />_ <br />_ <br />_ <br />_ <br />_ <br />_. <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />AIC— AIHANDLINGUNITS <br />FORCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT HEATERS <br />CLOTHES DRYER <br />RANGE HOOD . <br />WATER HEATER <br />METAL FIREPLACEISTOVE <br />FIREPLACE INSERT <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUST FAN <br />OTHER _ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <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 COMPLIED WITH 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 OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND 1 COMPLY WITH THE STATE <br />CgNTRACTORS LAW 18 27 RCW AND 298.200 WAC. <br />.11l at(-Le,L u( vLJImt, $I 00-7 <br />DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />