Laserfiche WebLink
� PERMIT APPLICA�''IfJN , <br /> CITY OF EVERETT PERMIT SER:�ICES � <br /> 3200 CEDAR STREET, EVERETT, WA 98201 f � <br /> •425-257-8810 — FAX 425-257-8857 z <br /> �i�3��' 190� <br /> PARCEL TAX I.D.H PERMIT# t <br /> SITE ADDRESS � <br /> 5to� E�IE��Q`.�( 4�IA-(- ��E��eT oosgr�►0000z3o� -ea�+e-co-�-� <br /> LEGA LOT NO. BLOCK Ti7ACT i <br /> oesc. (g� �j-t'�� p LEI��� D�'SC�l PT lOn1 + <br /> OWNER AODRE55 ZIP PHONE � <br /> ASSlSiA�CE LF1r�t1G �( �4zE7 �101 E�lZGRCGI rI/4 i- E��it 9oZQ3 i <br /> TENANT NAME I CONTACT NAME PHONE � <br /> �I A ' <br /> CONTRACTOR P��OT FIf E PI�OT�G� A�ORESS 21Q� '�O?� Q�'t �, Z�P CONTR. LICENSE q � <br /> "rAGoMA V,/A °I °04� < <br /> PHONE �253� °IZ� - ZZ°io � PAiRIfPo99C.F i <br /> PROPOSED USE OF BUILD�NG Building Mechanical Addilion HEAT SOURCE. ; <br /> T��(F� 51-IDP� ��F���S, PERMIT Comhinalion R�( Plumbing WORK Alleralion � Gas�dc I <br /> �GT�n�V R�7M 5� TYpE � Demolilion u Sign TYPE New ; <br /> n� Sprinkler FepaldMainl. Other <br /> KiT�H+�1 <br /> CONTRACT PRICE OF WORK �i ZG� ��6�� �5�j/.t,��/ , CITY OF EVEREIT LOCAL SALES TAX CODE IS 3105 <br /> WORK DESCFIPTION <br /> �nISiA LL A�c- ����nlri FIR� Pr�oicG i'�o►.� S�Iei�IKle 5�5 ►'c,� i <br /> T�-UZpJ��� oUt i.IL� $UIL�I+�I(� , ( i55 S�� �X�--��� � <br /> PLUMBING MECHANICAL � <br /> I <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OFi REM i <br /> WATER CLOSET _ A/�—NHANDLING UNITS i <br /> BATHTUB _ FORCED AIR SYSTEMS j <br /> LAVATORY (WASH BASIN) _ HEAT PUMP i <br /> SHOWER _ UNIT HEATERS ; <br /> KITCHEN SINK 8 DISPOSAL _ CLOTHES DRYER � <br /> DIS�iWASHER _ RANGE HOOD ; <br /> LAUNDRY TRAY _ WATER HEATER ,3 <br /> CLOTHES WASHER _ METAL FIREPLACE/STOVE <br /> URINAL _ PIREPLACE INSERT � <br /> DRINI:ING FOUNTAIN . _ GAS FIREPLACE <br /> FLCOR DRAIN _ GAS RANGE � <br /> BACKFLOW PREVENTER _ GAS PIPING <br /> SINK (SERVICE/BAFUMOP/ETC.) _ EXHAUST FAN <br /> OTHER _ OTHER � <br /> — I <br /> — i <br /> — � <br /> I HEREBY CERITIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL � <br /> PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR i <br /> NOT. THE GPANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOL4TE OR CANCEL THE PROVISION OF ANY GTHER <br /> STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br /> OWNER T IS PRO TY O PERFORA4 THE WORK FOR WHICH APPLICATION IS MADE AND I CQMPLY WITH THE STATE <br /> TRA S LAW 1 . 7 W AN 296. 0 WAC. <br /> u �.- � <br /> Signatur ot OwnedC nira todAulh rized geN Da e ��� <br /> � <br /> � <br /> � �-1z.35 j <br />