Laserfiche WebLink
' PEr�MIT APPLICATIOi� <br /> � CITY OF EVERETT PERMIT SERVICES <br /> � 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810— FAX 425•257-8857 <br /> I � <br /> iSITE ADDRESS PARCEL TAX I.D.N PERht1T w I <br /> ! a4 r�- w . C�,,,r,� 2d /6 �78o -Y�v--oo�o - /Goo !3o i i I-ozZ <br /> ILEGA LOTNO. BLOCK TRACT <br /> DESC. �� T_ f <br /> OWNER ADORESS 21P PHONE <br /> dOG <br /> l��{r��lR�Y� ICt4� :�:j:tlt Y'. r .�� _ �.�/S- -;.�� A�*C - �l�ifc /C�/O Jrn(/� 9R/OT� �iS -O�o�jO <br /> e <br /> TENANT NAME CONTACT NAME PHONE y rS <br /> l�v� ��ic�tn' � Q�•�. V;c�(SoM��.v' t,'��r.ra.!(/I�,<r�a ����� („?d-G7oG <br /> CONTRACTOR �g� ADDRESS ZIP CONTR.LICENSE M <br /> PHONE <br /> PROPOSED USE OF BUIL�ING .py�l Building � Mechanical Addilion HEAT SQURCE <br /> I PERMIT (� Combination Plumbing WUFK � A�tera��on I (� E�ecinc <br /> /�' TYPE Damolilion Sign fVPE New I Gae <br /> GtTICC- B Sprinkle� �apaiuMe�m. Y✓�!1 Otner <br /> CONTRACT PRICE OF WORK �y �,� CIT Y OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> WORKDESCRIPTION �1�(�. lihL��$ � (/10 (2�Pl3tfi�/�?�it �� p,� � /i`i/�/5� n� �/Jo/ t/r�+�� ,Sc�� 1 <br /> d !1'/n�r7 ) <br /> / <br /> PLUM8ING MECHANICAL <br /> NO. TVPE OF FI%TURE OR REM NO. TYPE OF FI%TURE OR ITEM <br /> _ WATER CIOSET A/C-A/HANDLING UNITS <br /> BATHTU6 FORCED AIF SYSTEM5 <br /> LA`lATORY(WASH BASIN) HEAT PUMP <br /> SHOWER UNIT HEATERS <br /> KITCHEN SINK 8 DISPOSAL CLOTHES DRYER <br /> DISHWASHER RANGE HOOU <br /> LAUNDRY TFiAY WATER HEATLR <br /> CLOTHES WASHER METAL FIREPLACE/STOVE <br /> URINAL FIREPLACE INSERT <br /> DRINKIfJG FOUNTAIN GAS FIRE?LACE <br /> FLOOR DRAIN GAS RANGE <br /> BACKFLOW PREVENTER GAS PIPING <br /> SINK �SERVIC68AR/MOP/ETC.) EXHAUST FAN <br /> OTHER OTHER <br /> I I <br /> iI HEREBV CEPITIFV'HAT I HAVE READ AND EXAMINED THIS APPUCATION AND KNOW THE SAME TO BE TRUE AND COFRECT. ALL <br /> PROVISIONS OF LAWS AND ORIDI�VACES GOVERNING TH�S TVPE OF WOFK WILL BE COMPLIED WITH WHETMER SPECIFIED HEREIN Ofi <br /> � NOi THE GPANTING OF 4 PERMIT DOES NOT PREgUME TO GIVE AUTHORIiV TO VIOIATE OR CANCEL THE PROVISION OF ANV OTHER <br /> STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERfORMANCE OF CONSTFUCTION. THAT I AM AUTHORIZED 8V THE <br /> � OWPJER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY W�TH THE STA7E <br /> CONTRACTORS LAW 18 27 FCW AND 296.200 WAC. <br /> / <br /> � �, � . � l/�to , bl <br /> Signawre ol OwnerrC �ec odAWhonzed Agenl ete � <br /> � �2 <br />