Laserfiche WebLink
c � <br /> � � PERIlAiT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 9 <br /> 425-257-8810-FAX 425-257 57 J1� ��'�cF <br /> �6 S <br /> SITE ADDRE58 I3Z� �'a�y R�` PAP.CEL TAX I.D./ I PE MI7 N��A � <br /> �1�t" 98?p d�3$5-2�le-aor� - aoaco .� -z� <br /> LEGAL LOTNO. BLOCK TRACT <br /> DESC. �� �1 <br /> ONMER ��(� � ADDRESS �.(p ��{�Y'�� ZIP PMOHE <br /> VY�k�OI[.�M_ G�-tyQ'�-� �! �A- �l .�ZS'250-Z Z <br /> TENANTNAME Vl CONTACTFORPERMR PMONE <br /> Vv.p�,IDtc.�+.. G�L 't7��lt� �,I�Cy![N3 4�5-ZS$-�`WZ <br /> CONTRACTOR ADORESS I�U2, �(JEh �'Q�'� LP CONTR.LICENSE• <br /> �������� �S�f7. ��! . <br /> PHONE 4Zs-!�6 -a4a� �ttt/�nn�s4-1� �V��A �82`La k►r�[��A2�z� <br /> PROPOSED USE OF BUILDING uilding f'1 Mechanical Addilion NEAT SOURCE <br /> I Iselad�� PERMIT Combination H Plumbing WORK eration Electric <br /> r�`��� TVPE DemOlitiOn lJ Sign TYPE New � Gas <br /> If1L � /y�p �.H/��� Sprinklef RepaidMain�. U Other <br /> K�ii � w�i ��..� <br /> CONTRACT PRICE OF WORK � �y� � CITV OF EVERETT LOCAL SALES TAX CODc IS�105 <br /> ��-% <br /> WORK DESCRIPTION ..�.�JIV'()'��,OF ��� � G�� VK«' aN <br /> cbvhf�Us. F��Espeic�r�es wtw P� !�� a-� ��t�lT f3�v�r�s Pt�E�.�RiM <br /> 5`ti`e'C'Ev`t�W lu.c3� Y`�'0'OE 1���0 ►ap�D �,� N�PS�E �hw*`lS'��M C�u�`�P <br /> hMUN� `�Jlb�w�Ak..U rtl � �'cr�o�t��p. w��t 6Pa�#Sl� �� <br /> PLUMBING M CHANI AL , <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> WATER CLOSET AIC–A/HANDLING UNITS <br /> BATHTUB FORCED AIR SYSTEMS <br /> 1 LAVATORY(WASH BASIN) _ HEAT PUMP <br /> SHOWER _ UNIT HEATERS <br /> KITCHEN SINK 8 DISPOSAL CLOTHES DRYER <br /> DISHWASHER _ RANGE HOOD <br /> UNDRY TRAY _ WATER HEATER <br /> CL ES WASHER METAL FIREPLACE/STOVE <br /> URINA FIREPLACE INSERT <br /> DRINKIN OU AIN GAS FIREPLACE <br /> FLOUR DRA GAS RIINGE <br /> BACKFlO P VENTER GAS PIPING <br /> SINK(S VICE/8 MOPIETCJ _ EXHAUST FAN <br /> � OTH _ OTHER <br /> � • — <br /> 1 HEREBY CERITIFV THAT I HAVE READ AND EXAMINE�THIS APPLICATION AND KNOW THE SAME TO BE TRUE AN�CORRECT. ALL <br /> PROVISIONS OF LAWS AND ORIbINACES GOVERN�NG 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 VIOII�TE OR CANCEI THE PROVISION OF ANY OTHER <br /> STATE OR LOCAL L�W a�GULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. TNAT I AM AUTHORIZ[D BV THE <br /> OWNER OF THIS PROPERTY TO PERF RM THE WORK FOR WHICH APPLICATION IS MADE AND 1 COMPLY WITH THE STATE <br /> CO �CTQRS W 1 27�W AND 96�200 WAC. <br /> ,�� 26 03 <br /> Signaturo of Owner/ onlractodAul orized�gent Datc �/ <br /> Z <br /> DEBIT& CREDIT CARDS ARE NOT ACCEPTED <br />