Laserfiche WebLink
-�` �'. <br /> ' ' PERMIT APPLICATION <br /> CITY OF EVERETY PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425- -8810- FAX 425-257- 857 ) �2 ���/�� <br /> SITE ADDRESS PA EL TAX I.D.N PERMIT M <br /> 0 ,2, 2 -O�� - oIZ - 020 �D/ � <br /> L GAL L T NO. BL K TRACT <br /> DESC. � N1(�(�II�I t'� �'1l� � <br /> O NER ADDRESS PHONE <br /> ��� 1 tY"\. DW ! �.SZ ►'l� S1.✓. L. ✓lnulo� �T�' 7��—�� !7 <br /> TENANT ME CONTACT NAME PHQNE <br /> �� <br /> CONTRACTOR��n- ���� ADDRESS COL�.UCENSE M <br /> WL I �ZG r `` SGE �'RAI,u'(f� <br /> PHONE � � ��� <br /> 1,.5 �E A <br /> PROPOSED USE OF BUILDING Building n Mechanical AddMlon HEAT SOURCE <br /> 4� PERMIT � Combinetion r� Plumbing WORK B Alteretion � FJectAc <br /> �c`���r. TYPE DPmolitfon D Sign TYPE P� New (ies <br /> 7 p S nnkler D RepeldMalnL Olher <br /> CONTRACT PRICE OF WORK CT"UF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> WORK DESCRIPTION <br /> � �a�A�a���� 6� N�� `N��►��A�,,�� � ��� . <br /> P BING MECHANICAL <br /> NO. � TYPE OF FlXTURE OR REM N0. TYPE OF flXTURE OR REM <br /> WATER CLOSET _ A/C-AMANDLING UNITS <br /> BATHTUB FORCED AIR SYSTEMS <br /> LAVATORY(WASH BASIN) _ HEAT PUMP <br /> SHOWER _ UNIT HEATERS <br /> Kll'CHEN SINK 8 DISPOSAL CLOTHES DRYER <br /> DISHWASHER RAN(iE 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 RANCaE <br /> BACKFLOW PREVENTER GAS PIPING <br /> SINK(SERVICE/BAR/MOP/ETC.) _ EXHAUST FAN <br /> OTHER OTNER <br /> — — <br /> — JP � — <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 Ofl <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br /> STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFOHMANCE OF CONSTRUCTION. THAT I AM AUTHORI2ED BY THE <br /> OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE ' <br /> CONTRACTORS LAW 1827 RCW AND 298200 WAC. <br /> �' P"� �'�/� I <br /> �ignature of�`/ ! ed Agent ' at� �IZ <br />