Laserfiche WebLink
P�RMIT APPLICATION <br /> C17Y OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 9A201, 425-257-8810 <br /> �o - 9�oL <br /> SITE ADDRESS PARCEL TAX I.D.N PEAMIT p <br /> � � � 2 � �Iy ' -�oo - a�-IB�0203 e2o�-0�4 <br /> LEGAL L NO. BLOCK TRACT c.�f 1` <br /> DESC. �2 i L � �- V� W �I �.1 WT� <br /> � <br /> OWNER ! AODRESS � PHONE <br /> }�l e rl n�-t W (� � n� <br /> JA1`�E� � »N�F:r-� ' � 11�� C.AOr� IW C�f1�� i�Z� '�j5`��'U�o3�� <br /> TEN NTNAME CONTACTNAME <br /> PHONE <br /> �1 � I�Y�� r�n e-� N �tt��.��1 iy?,�-355� 2(�35 <br /> CONTRACTOR �'�l L � ! ADDRESS i CONTR. LICENSE M <br /> PHONE i <br /> � i <br /> i <br /> PROPOSED USE OF BUILDING n Building n Mechanic3l Addition HEAT SOURCE <br /> PERMIT ISb Combination n Plumbin WORK AReration � Eiectric <br /> 5�����{ �Am��e1 eF'� . ryae I`T Demolition D Sign 9 TYPE New Gas <br /> D Sprinkler Repeir�Maint. Other <br /> CONTRACT PRICE OF WOfiK �' -' � - ("O qTY OF EVERETT LOCAL SALES TA%CODE IS 3705 <br /> i .i .� Ir� _ <br /> WORK DESCRIPTION AOO �Q2 (�E �N p CY�E.N'Jlp r�f '`� F�i�T Q�.� V <br /> -t'�iY ✓_ G-�' ��OV.'.�E_ It-� ��uOE.b Y'��v�7 2eom1"P�ZE�AKFOY, `Roo �— <br /> (� U���2 �P�(�511 � I �� C (LFP �C S1�.� a�} VVIf��'SE(L G�CoR-oo �� <br /> �a-,� l�n� E"� <<-,.�� f �� N�•- • � ��;C �� 7r�,� �-= . <br /> �LUMBING ME HANI AL <br /> N0. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIJ(TURE OR ITEM <br /> � WATER CLOSET Pu'C-A/HANDLING UNITS <br /> _ BATHTUB � FORCED AIR SYSTEMS <br /> �_ LAVATORY(WASH BASIN) HEAT PUMP <br /> SHOWER UNIT HEATERS <br /> �_ KITCHEN SINK 8 DISPOSAL CLOTHES DRYER <br /> __ DISHWASHER RANGE HOOD <br /> _ LAUNDFY TRAY _L WATER HEATER <br /> CLOTHES WASHER _ METAI. FIREPLACE/STOVE <br /> _ URINAL FIREPLACE INSERT <br /> __ DFINKING FOUNTAIN _ GAS FIREPLACE <br /> _ FLOOR�RAIN _ GAS RANGE <br /> BACKFIOW PFEVENTER � GAS PIPING <br /> _ SINK(SERVICE�BAR/MOP.�ETC.) � EXHAUST FAN <br /> OTHER__ _ OTHER <br /> 1 HEREBV CERI7IFV THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TFUE AND CORRECT. ALL <br /> PROVISIONS OF IAWS AND ORIDINACES GOVERNING THIS TVPE 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 OF CANCEL THE PROVISION OF ANV OTHER <br /> STATE OR LOCAL LAW REGUUITING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PPOPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MAOE AND I COMPLY WITH THE STATE <br /> CONTR.4CTOR5 LAW 1B 2%RCW AND 296200 WAC. <br /> ,I'".i�r,,,,1 � c?� •.���• N l Dn�_ <br /> ��� '� <br /> Signature ol OwneriContractor/Aut zed Agent Dat �j <br /> Z <br />