Laserfiche WebLink
. P�RIVIIT APPLICATIL.� <br />� CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 <br />SITE ADDRESS <br />LOT NO. <br />Cr <br />��PN �i' n_ �- � I_;�SL'. J� <br />TENANT NAA7E <br />:c�.ssK C:ouSTRue <br />PHONE e.-t( <br />�is-a31�3 d5 <br />PROPOSED USE OF BUILDIN <br />CONTRACT PpICE OF WORK <br />WORK DESCRIPTION <br />BLOCK <br />�, �:'�N'�f►ro��� PERMIT M <br />ADDRESS � ZIP PMONE <br />�r ..�fT%✓e ��1d� �� � `� �'-�� <br />CONTACTNAME <br />PHONF <br />AO RESS P CQNTR. IICENSE • <br />aeH,.�'jvc� po�e�r 3G�3 Atcr,�Gra.✓w,� �pst3 oo4soeses�nlJ <br />Building Mechanical <br />PeRMIT Combination R�J Plumbing <br />TYPE Demolilion u Sign <br />Sprinkler <br />Addition <br />WORK Alteralion <br />TYPE New <br />Repair/Maim. <br />HEATSOURCE <br />Eiectnc <br />Gas <br />Other <br />CITY OF EVERETT LOCAL SALES TA% CODE IS 3105 <br />%�Q � S C C.l�+S $(�0 � S 1C `(0 RFT Cc S ia o pE,�! r4�� <br />NO. I TVPE OF FIXTURE OR ITEM <br />� _ WA7ER CLOSET <br />i_ BATHTUB <br />i _ LAVATORY (WASH B.4SIN) <br />SH0INFR <br />' KITCHE�J SINK 8 DISPOSAL <br />i _ DISHWASHER <br />� _ LAUNDRY TRAY <br />� _ CLOTHES WASHER <br />� _ URINAL <br />i _ CRINKING FOUNTAIN <br />FLOOR DRAIN <br />� BACKFLOW PREVENTcR <br />� �'_ SINK (SERVICE/BAR/MOP/ETC.) <br />OTHER <br />ND. I TYPE OF FI7(TURE OR REM <br />A/C — NH�\NDLING UNITS <br />_ FORCED flIR SYSTEMS <br />_ HEAT PUMP <br />_ UNIT HEAI'ERS <br />_ CLOTHES DRYEH <br />_ RANGEHOOD <br />_ WATER HEATER <br />METAL FIREPIACE�STOVE <br />_ FIREPLACE INSERT <br />� GAS FIRE?LACE <br />GAS RANGF_ <br />_ GAS PIPING <br />_ EXHAUSTFAN <br />_ OTHER <br />I HEFEBY CERITIFY'NAT I HAVE READ AND EXAIdINED THIS APPUCATICN ANO KNOW THE SAtdE TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND OfiIDINACES GOVERNING THIS 1YPE OF WGRK WILL BE COMPIIE� WI7H WHETHEfi SP[CIFIED HEFEIN OR <br />NOT. THE GRANiING OP A PERMIT DOES NOT PRESUME TO GIVE AUTHORIN TO VIOLi1TE GR CANCEL THE PfiOVISION OF FNY GTHER <br />STATE OR LOCAL LAW REGUWTING CONSTRUC710N OR THE PERFORh1ANCE OF CONSTFUCTION. THAT I AM AUTHORIZED BY THE <br />OWNEF OF THIS PFi PEFTY 70 PERFO 7 THE WORK FOR WHICN APPLICATION IS h1ACE AND I COAIPLY WITH THE STATE <br />CON,T�RAy TORS LA4`� 16.27 R' AND 29 .200 WAC. <br />/%%��, � Ru�zo�.lr ralr�ll��. <br />'a <br />