Laserfiche WebLink
sire <br />� <br />`� <br />LOT NO. <br />TENANTNAME <br />�. �ERIVIIT APPLICA''..,O�l <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 <br />BLOCK <br />�C}'�' US �� V � rWMYCu <br />CONTRACTOR (Q� �,r '7 ( V �µ� �� <br />Y r <br />PHONE ��� ` �3_!70 <br />b <br />PROPOSEO USE OF BUILDING <br />(�fi N�. <br />CONTRACT PRICE OF WOFK <br />WORK �ESCRIPTION <br />PLUMBING <br />NO. � TYPE OF FIXTURE OR ITEM <br />PARCEL TAX I.D. N <br />TRACT <br />AOORESS <br />CONTACTNAME <br />i% / /i.. <br />AODqESS � (�� <br />/v oc.{[` <br />L1J 19" <br />S-F=.�i�(.,,,q-y z�P <br />�etc'j'4't�C_ <br />/O'� <br />8uilding �jji�� Mechanical <br />PERMIT R Combinalion � Plumbing <br />TYPE � Demolilion Sign <br />Sprinkler <br />NO. <br />� V�',aTER CLOSET <br />_ BATHTUB <br />LAVATORY (WASH BASIN) <br />_ SHOWER <br />KITCHEN SINK 8 DISPOSAL <br />DISHWASHER <br />LAUNDFiY TRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />Z FLOOR DRAIN <br />BACKFLOW PREVENTER <br />SINK (SERVICE/BAR/MOP/ETC.) <br />� OTHER �1v7' WorYt� -��� f � <br />�SS�a� <br />a <br />G <br />PHOi�E <br />3L�/i� <br />COP;TR. LICENSE q <br />�rsT�,��7.3Cv <br />Addillan I HEAT SOURCE <br />Iteralion Q Eleclric <br />New �j Gas <br />fiepair/Maint. �.) Other <br />CITY OF EVEFETT LOCAL SALES TAX COOE IS 3105 <br />NL•CHANICAL <br />TYPE OF FIXTURE Oi� ITEM <br />A/C -A/HANDLING UNITS <br />FORCED AIR SYST[MS <br />HEAT PUMP <br />UNIT HEATERS <br />CLOTHES DRYER <br />RANGEHOOD <br />�VATER HEATER <br />METAL FIREPLACE/STOVE <br />FIREPLACEINSERT <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUSTFAN <br />OTHER <br />I HEREBY CERI7IFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND COFRECT. ALL <br />PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHECHEA SPECIFIED HEFEIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT?RESUME � 0 GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br />STATE OR LOCAL LAW REGUTATING CONSTRUCTION Oq TNE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PEf�FORM THE WORK Fi^,R WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRAQ70RS LAW 18.27 RCW /SNU 296200 WAC. <br />�! � <br />