Laserfiche WebLink
--, <br /> � ERMIT APP�ICAT�'�N <br /> CITY OF EVERETT PERMIT SERVECES <br /> 3?00 CEDAR STREET, EVEREIT, WA 98201 <br /> 425-257-8610- FAX 425-257-8857 <br /> SITE ADORESS PARCEL TAX I.U. # PERMIT a <br /> ��30 �,i.�c � w � ��-? � � �03�; <br /> �ESG LOTNO. BLOCK TRACT 'q� /,n�^ �y��J ,�� <br /> 3PS' d SE �• D ..3{� ) <br /> OWNER\ �m O�c Ob AV, y� ('� ADORESS ZIP PtIONE <br /> �5 "` '� � � 1-�1MY��(Jc � � <br /> � ^ I <br /> TENANTNAME�/ �, � CONTACTNAME PHONE <br /> I �� <br /> �c���l o�� , 1 r ���,Y�Go�sw�a � �I Zb—�5°1- �/� D <br /> CO-NrT�FACTOR ADDRESS ZIP CONTR.LICENSEA <br /> PHONE�/� s� -� /�O�IS'��Z...VC�'�r 'c�/ W I �Z.S �V�--i��� ��ZA I �SCD ���I�FF <br /> �( L-7��-"rl—' Tl D � <br /> PROPOSED USE OF BUILOING b� Building fl Mechanicdi Addi�ion HEAT SOURCE <br /> ^ PERMIT ��_�Combination �� Plum6ing WORK Alleration Electric <br /> � '7 / TYPE � j Demolitian IJ Sign TYPE New Gas <br /> ia� �,v�, L� Sprinkier RepaidMain�. Other <br /> CONTRACT PRICE OF WORK ���, �-� CITY OF EVERETT LOCAL SALES TAX CO�E IS 3105 <br /> WORK OESCFiIPTION <br /> �'� <br /> • / <br /> PLUMBING MECHANICAL <br /> � N0. TYPE OF FIXTURE OR ITEM N0. TYPE OF FIXTURE OR ITEM <br /> _ WATERCLOSET _ A/C–A/HANDLINGUNITS <br /> _ BATHTUB _ FORCED AIR SYSTEMS <br /> _ LAVATORY(WASH BASIN) _ HEAT PUMP <br /> _ SHOWER _ UNIT HEATERS <br /> _ KITCHEN SINK& DISPOSAL _ CLOTHES DRYER <br /> _ D�SHWASHER _ RANGE HOOD <br /> _ LAUNDRY TRAY _ WATER HEATER <br /> CLOTI�ES WASHER _ METAL FIREPLACE/STOVE <br /> _ URINAL _ FIREPLACE INSERT <br /> DRINKING FOUNTAIN _ GAS FIREPLACE <br /> _ FLOOFI DRAIN _ GAS RAMGE <br /> _ BA�KFLOW PREVENTER _ GAS PIPING <br /> SINK(SERVICE/BAR/MOP/ETC.) _ EXHAUST FAN <br /> _ OTHEF _ OTHER <br /> I HEREBY CERITIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND COfiRECT. ALL <br /> PFOVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TYPE OF WOFK WILL 8E COMPLIeD WITH WNEfHER SPECIFIEO HEREIN OR <br /> NOf. THE GRANTING OF A PERMIT DOES NOT PRESUAIE TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br /> STATE OR LOCAL LAW REGULATING CONSTRUCTION OF THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY;O PERFORM THE WORK FOR WHICH APPLICATION IS MAOE AND I COMPLY WITH THE STATE <br /> C OFS LAW 18.27 R AND 296.2 WAC. <br /> � � <br /> Si nature ol ne nt ctor uthorized Ag t Date � <br /> Z <br />