Laserfiche WebLink
P-RMIT APPLICATI -)N <br />�T CITY OF EVERETT PERMIT SERVICES <br />_ 3200 CEDAR STREET, EVERETT, WA 98201, 425-257-8810 <br />CKI-,10 <br />SITE ADDRESS PARCEL TAX I.D.# PERMIT# . <br />--Te30 <br />93 s1 ti1V, EVERETT, WA 98204 uu531 )00330o ��� �� 1 ` <br />LEGAL LOT NO. BLOCK TRACT <br />DE$ <br />OWNER <br />ADDRESS <br />PHONE <br />MOI:N, KERRtiNCt? <br />930 93 ST SW <br />14250,17•h710 <br />TENANT NAME <br />CONTACT NAME <br />PHONE <br />PAML•LA HILL <br />425 814.3121 \I , <br />CONTRACTOR <br />ADDRESS <br />CONTR.LICENSE# <br />PAST WA*1 ER 111 A I I R COMPANY <br />12v01 132ND AVE NE <br />FASTWHCU52DI' <br />PHONE (425)814-3124 <br />KIRKLAND. WA 98034 <br />02'16'2005 <br />PROPOSED USE OF BUILDING Bulldinp Mechenica Addillon H T SOURCE <br />PERMIT Combinellan Plumbinp WORK Allereaon Electric <br />- <br />TYPE Damotilion Sipn TYPE New ee <br />r r - Re elr/Malnl Cher <br />CONTRACT PRICE OF WORK 144900 CITY OF EVERETT LOCAL SALES TAX CODEIS 3105 <br />WORK DESCRIPTION <br />Remove/Replace G;n kk alcr I Ivaicr <br />PLUMBING <br />MECHANICAL <br />TYPE OF FIXTURE OR ITEM <br />O. TYPE OF FIXTUR R ITEM <br />WATER CLOSET <br />------- <br />A/C•A/HANDLING UN;TS <br />BATHTUB <br />— _____ <br />FORCED AIR SYSTEMS <br />______ <br />LAVATORY (WASH BASIN) <br />HEAT PUMP <br />__--_ <br />SHOWER <br />UNIT HEATERS <br />------- <br />KTCHEN SINK 3 DISPOSAL <br />_ <br />— <br />CLOTHES DRYER <br />DISHWASHER <br />__� _ <br />RANGE HOOD <br />LAUNDRY TRAY <br />— I <br />WATER HEATER <br />—__ <br />CLOTHES WASHER <br />--___ <br />METAL FIREPLACE/STOVE <br />URINAL <br />— _ <br />FIREPLACE INSERT <br />— _ <br />DRINKING FOUNTAIN <br />GAS FIREPLACE <br />_ <br />FLOOR DRAIN <br />_ <br />GAS RANGE <br />—----- <br />BACKFLOW PREVENTER <br />— <br />GAS PIPING <br />—_—__ <br />SINK (SERVICE/BAR/MOP/ETC.) <br />,—` <br />EXHAUST FAN <br />---- <br />OTHER <br />OTHER______ <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APLICATION AND KNOW THE SAME 1 DE TRUE AND CORRECT ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WIHT WHETHER SPECIFIED HEREI <br />OR NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED <br />BY THE OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICA1ION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 298.200 WAC. <br />Signature of Owner/Contractor/Authorized Agem . .r Date <br />1 V032004 <br />u, oil <br />