Laserfiche WebLink
SITE ADDRESS <br />NO. <br />� <br />PERMIT APPLICATION <br />CITY OF EVERETi' PERMIT SERVICES I'�, <br />3200 CEDAR STREET, EVERETT, WA 98201 �ji,,, <br />425-257-8810 - FAX 425-257-8857 <br />PARCEL TAX �.D. # <br />. aA. `+82o Z$oy��oo-so�-7ot <br />BLOCK TRACT <br />�j��7�t o;-0�3 <br />��'�� <br />�U �/vl �Dll <br />St�2T-Nt �G1 N683 Gh46et �i�L.SJ�f� luo P/ensa�h� GA �i'iSdp ya,�-8�s dzc�v <br />TENANT NAME C�pNTACT FOR PERMIT PHONE <br />l�t�trov� CAL1y��e� zl `��-�%5�{- 3�/50 <br />__ Cn;�, Ga...p � �(Z..s'-67o-d6S� <br />CONTRACTOR `r,�_D ADDRESS <br />PHONE ��/ �i �� CC/�5�� <br />PROPOSED USE OF BUILDING <br />W IRex.E,SS <br />CONTRACT PRIG�E OF WORK <br />PERMIT <br />Tvre <br />j� Building <br />f"� Combination <br />f� Demolition <br />D Sprinkler <br />D Mechanical <br />U Plumbing <br />U Sign <br />ZIP CONTR. LICENSE N <br />Addition HEATSOURCE <br />ARerelian � Eledric <br />N�w Gas <br />Repair/Mainl. Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />WORKDESCRIPTION �hC� iny}�•��w(iv� � N�7r,v�t' (Pcs)7eleco�-Mu„,-c"�iT-.7 �Gi6-Fr Con1i� j•� r <br />� <br />a �-e�Orte� SO •O�� 1-Ir�M /10�o�olt� ��'t'� 3qv�itnna� �e1^���q.� cSSoer•te�� �7�,��'�+r�"i <br />ra b,reh on �� co..c�e jp sI4L 5r ��L.� 6�ye. ot i1-a-P°�e� C��clole� w�i'ln n 6�_o„yr�h Gha,h <br />�,-..�� scc«�,yy Fe�ce. <br />NO. � TYPE OF FIXTURE OR ITEM <br />WATER CLOSET <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK & DISPOSAL <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />ORINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTER <br />SINK (SERVICE/BAR/MOP/ETC.) <br />OTHER <br />NO. I TYPE OF FI7(TURE OR ITEM <br />A/C-AIHANDLI�G UNITS <br />FORCED AIR SYSTEMS <br />HEAT PUMP <br />�JNIT HEATERS <br />CLOTHES DRYER <br />RAN6EHOOD <br />WATER HEATER <br />METAL FIREPLACJSTOVE <br />FIREPLACE INSERT <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUSTFAN <br />OTHER <br />I F'EREBY CERITIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE ANC I;ORRECT. ALL <br />PRO�ISIONS OF LAWS AND ORIDINACES GOVERNING THIS NPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOE� NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br />STATE OR LOCAL LAW REGULATING CONSTRUCTI01� OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED B'/ THE <br />OWNER OF THIS PROP�RTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTOR LAW �18.27 RCW AND 296200� '� n/-/��� <br />ll <br />Signa ure of Owner/ContractorlAuthorize � t Date <br />DE�IT & CREDIT CARDS /aRE NOT ACCEPTED 1/L <br />