Laserfiche WebLink
t� ' 1 ,� <br /> PEI�MIT APPLICATIO�I� <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201, 425-257-8810 <br /> SITF ADDRESS C�.R72Ms� PL�2i} pARCEL TAX I.D.# PERMIT k <br /> ���'S' ES�E��='C�'7� �✓ � ���� —�� <br /> LEGAL LOT N0. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRESS PHONE <br /> PPo� P�1Ti� P�c�z-GxTy's z ��3 roY�iN� s�, ,�t 9�� (,2s3) 8s�-.�J� � <br /> TENANTNAME CONTACTNAME I PHONE <br /> /�r.lEtC"L l�wc�2 �S <br /> CONTRACTOR ADDRESS CONTR.LICENSE!'i <br /> (33�FT 5 i�N St.�2u�cc S � �,2�z 3��t�-�-- tn/1�y S�- p <br /> PHONE ��k'LS� 3�u— ��(oc ( i1•1ll.l. CQ.�L� LJ� �l(Y�1 L ��J%S�,S����� <br /> PROPOSED USE OF BUILDING Building � Mechanicai Addition HEAT SQURCE <br /> ' t PERMIT B Comhination Plumbing WORK � Alierauon D Elec+ric <br /> T-�f�l� C��S TYPE � Demolition Sign TYPE New D Gas <br /> Sprinkler Repair/Maint �� Other <br /> CONTRACT PRICE OF WORK ��pp'•Z CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> WORKDESCRIPTION '�JS.��� C:��. S �T iJ� Gk�P�fVNc7— l.�-7(E7Z5' .2�/�� Q' /� �� <br /> i�"Y✓/J U/✓C S�i=� sff71��� � 5�/6n/ /'Z, i�X 5-,� �i <br /> C�sl�/,✓�T <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF FIXTURE OR ITEM N0. TYPE OF FIXTURE OR ITEM <br /> WATER CLOSET 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 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 /> FLOOR DRAIN GAS RANGE <br /> BACKFLOW PREVENTER GAS PIPING <br /> SINK(SERVICE/BAR/MOP/ETC.) EXHAUST FAN <br /> OTHER OTHER <br /> I HEREBY CERITIFY THAT I HAVE READ AND EXAMINED'fHIS APPIICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br /> PROVISIONS OF L16VS AND ORIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEHEIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOIATE OR CANCEL THE PROVISION OF ANY OTHER <br /> STATE OR LOCAL LAW REGULATING CONSTRUCTION OR TI1E 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 /> CONTFACTORS LAW 18.27 RCW AND 296200 WAC. <br /> � ���/0� <br /> Signature of OwnedContractodAuthonzed Agent Date <br /> . a� <br />