Laserfiche WebLink
� cRMIT APPLICATIvN <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, V1�A 98201 <br /> 425-257-8810- FAX 425-257-8857 <br /> SITE ADDRESS E(��G� ���� PARCEL TAX I.D.N PERMI7 K <br /> �.d� q�ao -c7� y�90 7i o 00 �o3�z-�zH <br /> LEGA LOT NO. BLOCK <br /> DES0. <br /> OWNER ADURESS LP PHONE <br /> Ax�+��E Ar,��A� 2r� B,��j�iarA �v�,��Tr 9�av! �y.�.�)asF��?� <br /> TENANTNAME CONTACTNAME PHONE <br /> ��.T���� � r�,�,�k �,��k /Gi�s)as�-a�3� <br /> CONTRACTOR ADDRESS �'ZIP CONTfl.LJGEfi$E R <br /> PH���_T�,�,�� �,� � � �oa� ��7 ,U0�1HZ'Gday-� <br /> C��nAS u/A <br /> PROPOSED USE OF BUILDING Building I� Mechanical lon HEAT SOURCE <br /> PERMIT Combinalion E_� Plumbing WORK Alteratlon � Electric <br /> TYPE Demolition Ll Sign TYPE New Ges <br /> Sprinkler(F o1 heads) Repair/Maint. Other <br /> CONTRACT PRICE OF WORK �•) !,�^ -- 'CITV OF EVERETT LOCAL SALES TA%CODE IS 3105 — <br /> G�(/(A/ <br /> WORK DESCRIPTON — ADD '�� <br /> Fv1 n�r ,v;u� �.t�A l l — D�►�G a10 c�rl�� <br /> .�P G�il1� - ,v�ul U.�.cJ.�i( F�� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF Fl%TURE 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 8 DISPOSAL CIOTHES 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 /> FLOOR DRAIN _ GAS RANGE <br /> BACKFLOW PREVENTER _ GAS PIPING <br />, SINK(SERVICE/8AR/MOP/ETC.) _ EXHAUST FAN <br />, OTHER _ OTHER <br /> I HEREBY CERITIFV THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br /> PROVISIONS OF LAWS AND ORIDINACES GOVEflNING THIS TYPE OF WORK WILL 8E COMPLIED WITH WHEfHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PEflM1T 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 CONSTRUCT�ON. THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WI7H THE STATE <br /> CONTRACTOR9LAW 1827 RCW AND 296.200 WAC. <br /> , /� <br /> �� =� ��� �r� a/i� 03 <br /> , <br /> Signa �ot Ow�er/Cont otlAuthonzed Agent at �Zj <br /> � <br />