Laserfiche WebLink
FERMIT APPLICATIUN _ ; �������q�� � �,���, <br /> CITY OF EVERETT PERMIT SER`/ICES ' '� � <br /> 3200 CEDAR STREET, EVERETT, WA 98201 ,IUN � '] 2005 <br /> 425-257-8810 — FAX 425-257-8857 1 <br /> �; � �"i(s� .� `� I <br /> SITEADDRESS1_ PARCRTAXI.D.p ��1M�7x�` EVERET� <br /> I�(L� `• oJl� � SS - � � .'tll]�Pllhl'(ICM�Yrr <br /> LEGAL LOTNO. BLOCK TRACT <br /> DESC. <br /> OW R ADURESS 21P PHONE <br /> I 0 na Lf�-I ? uVG I�27 /�DO���-f 51.t� �SS �LS 3S� �8Z <br /> TENANT NAME I CONTACT FOR PERMfi PHONE <br /> CONTRACTOR ��/► ADDFESS � /� ZIP CONTR. LICE 3� *� E <br /> � 5 � • urlc��n (,�A 4�t33 � y <br /> PHONE�D �`��,0933 — <br /> J <br /> PROPQSED USE OF BUILDINfj n Building C) Mechanica Addit�on HEAT SOURCE <br /> 5in�� 1� m //�� PERMIT K Combinalion L) Plumbing WORK Alteretion R Eiectric <br /> �"1�l• ��� TYPE �_� Demolition L> Slgn TYPE New �J Gas <br /> U Spflr.kler RepairlMaint. L) Olher <br /> CONTRACT PRICE OF WORK -��O�O , CITY OF EVERETT I.GCAL SALES TAX CODE IS 8105— <br /> WORK DESCRIPI'ION � <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF FIXTURE OR ITEM NO. I TVPE OF FIXTURE OR ITEM <br /> WATER CLOSET(TOILET) _ A�C-A/FIANOLING UNITS I <br /> BATHTUB __ FORCFD A�R SYSTEMS � <br /> LAVATORY (WASH BASIN) _ HEAT PUMP � <br /> SHOWER _ UNITHEATERS <br /> KITCIIEN S�NK 8 DISPOSAL _ CI:�THES DRYER <br /> DISHWASHER _ RA�1GE HOOD <br /> LAUNDRY TRAY _ WAI�ER HEATER <br /> CLOTHFS WASHER _ METAL FIREPLACE/STOVE <br /> URINAL _ FIREPLACE INSERT <br /> DRINKING FOUNTAIN GA5 FIREPLACE <br /> �100R DRAIN GAS RNNGE <br /> [ 4CKFLOb"/ PREVENTER _ GAS PIPING <br /> 5 VK (SERVICE'BAR/MOPIETC.) _ EXHAUST FAN <br /> _ O1�1ER_ _ = OTHER i <br /> �� � HEREBV CERITIFV THAT I HAVE READ AND E?(A1diNED THIS APPLICA7iON AND NNOW THE SAME TU BF TRUE AND CORRECT. ALL I <br /> PROVISIONS OF L4WS AND OftIDINACES GOVERNING THIS TVPE OF WvRN�YILL Bc COMPLIEO WITH WHETHER SPECIFIED HEREIN OR <br /> �JOT THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUl'HORITY TO VIOII�TE OR CANCE:THE PROVISIOh OP ANV OTHER <br /> STATE OR LOCAL LAW REGUU+TING CONSI"RUCTION JR THE PERFORMANCE OF CONSTRUCT!ON. THAT I AM AUTHORIZED BV THE <br /> HIS PROPERTY 70 PERFORM THE`.NORK F�R'NHICH AP?LICATION IS MADE AND I COMPLY'NITH THE STATE <br /> � ( JNTRACT RS LAW 18< AND 296.200 WAC <br /> a�i ' D�.�t s -2-05 II <br /> SignaWre of Owr,er/ onlrac nAuthorized A9en1 Dale <br /> I DE81T 8 CR[DIT CARDS ARE NOT ACCEPTED <br />