Laserfiche WebLink
4PERMIT.APPLICAIION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810- FAX 425-257-8857 <br /> 19 -0// <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT# <br /> 6180 46 k" fmore <br /> LEGALI LOT NO. BLOCK TRACT <br /> DESC. <br /> OW ADDRESS SaO ,w 2 d'(, �� ZIP PHONE <br /> ye,f_e_ .e�� © � j cteri , BWos. .P 6. .ISte/r-T6-f ccs <br /> 1 o6- 334 o/Z6 <br /> TENANT� NAMEQS CONTACT FOR PERMIT PHONE <br /> ` `�1NicAve1I £'. Q -xc 'mi e ,1 •e Lav `Q Q ©CaA7I s"--S6 <br /> CONTRACTOR {-,g1-r& I-ayb tYAl ADDRESS &'D/ LQAGK,-ed 121Z•, ZIP CONTR.LICENSE# <br /> evc=[ee3t qgz I f©STE60g3 Q <br /> PHONE 5Zw LZl Z <br /> : �6 330 0-79/ &ATE <br /> PROPOSED USE OF BUILDING Building Mechanical Addition HEAT SOURCE <br /> PERMIT CombinationIIQv�( Plumbing WORK Alteration Electric <br /> 0 o TYPE Demolition Sign TYPE New Gas <br /> `Q e 1,_\--okse Sprinkler Repair/Maint. Other <br /> CONTRACT PRICE OF WORK l(aj© ov I CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> WORK DESCRIPTIOz.N nodg_ t 'Sl0‹f wf Tre4/nesnee/ ©4 - flt/°64SW1 sihk dine- it arilwash5/s4, <br /> ore 3-Aasop v � aid Z 1tiw4--040 va(ye,f g&e. £spReoso rn and Be_c- ,eKe-4 <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO.. TYPE OF FIXTURE OR ITEM <br /> WATER CLOSET(TOILET) A/C-A/HANDLING UNITS <br /> __ BATHTUB FORCED AIR SYSTEMS <br /> LAVATORY(WASH BASIN) HEAT PUMP <br /> SHOWER UNIT HEATERS <br /> KITCHEN SINK&DISPOSAL CLOTHES DRYER <br /> DISHWASHER RANGE HOOD <br /> LAUNDRY TRAY WATER HEATER <br /> CLOTHES WASHER METAL FIREPLACE/STOVE <br /> URINAL . FIREPLACE INSERT <br /> DRINKING FOUNTAIN GAS FIREPLACE <br /> — <br /> 2. FLOOR DRAIN GAS RANGE <br /> BACKFLOW PREVENTER GAS PIPING <br /> `'b.. SINK(SERVICE/BAR/MOP/ETC.) EXHAUST FAN <br /> OTHER OTHER <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 I COMPLY WITH THE STATE <br /> CONTRACTORS, W 18.27 RCW AND 296.200 WAC. <br /> Signature of Owner/Contractor uthorized Agent Date <br /> DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />