Laserfiche WebLink
SITE ADDRESS <br />LOT NO. <br />�a1LN�S i <br />TENANT NAME � N,(_, „ <br />CONTRACTOR Sq ' � �v <br />PHONE <br />uas-No�-i <br />PROPOSED USE OF BUILDING <br />CONTRACT PRICE OF WORK <br />WORK DESCRIPTION <br />NERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, Wh 98201 <br />425-257-8810 - FAX 425-257-8857 <br />PARCEL TAX I.D. R <br />�Z-I5�0 <br />BLOCK TRACT <br />COriTACT NAME <br />s�l �� <br />�L�L ADDRESS QL��S o�1�1 �_ <br />ST��/oa� hk'�oQ <br />Building Mechanical <br />PERMIT � Combinaf.;on � Plumbing <br />7YPL Demolition Sign <br />Sprinkler <br />i�s-; �t-�-� a1�t LAS�k��( <br />-r�{-�G-� c-AfS . <br />NO. I �PE OF FI%TUqE OR ITEM <br />WATER CLOSET <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 DISPOSAL <br />DISHWASHER <br />UIUNDRY TRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENT[R <br />SINK (SERVICE/BARlMOP/ETC.} <br />O'HER <br />� <br />�' G3 � 1-DO I _ <br />� <br />PERMIT M <br />PHONE <br />y� ZIP CONTR. [L,IC,ENSE M <br />/LLE� 9SO1a �t�'C�l�=D <br />�Addilton <br />Alteralion <br />New <br />Repair/Ma(nt. <br />HEATSOURCE <br />�i Electrk <br />B Gas <br />Olher <br />CITY OF EVERETT LOCAL SALES TAX COOE �5 3706 <br />PLJM6i�1G F'o� 'T1.�n T�lLcTS A-/J� <br />N0. I T1'PE OF FlXTURE OR ITEM <br />A!C - A/HANDLING UNITS <br />FORCED AIR SYSTEMS <br />_ HEAT PIIMP <br />UNIT HEATERS <br />CLOTHeS DRYEF <br />RANGEHOOD <br />_ WATER HEATER <br />METAL FIREPLACE/STOVE <br />FIREPLACE INSERT <br />GAS rIREPLACE <br />_ GAS RANGE <br />_ GAS PIPING <br />EXHAUST FAN <br />OTHFR <br />I HEREBY CERITIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION ANO 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 HEHE�N OR <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 LA� RE ING CONSTRUCTIOPI OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />pWNER'Q)F THIS P9A�ER TO P FORM THE WOflK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />����9bs�uiaG i�diN �a.2h B ND 296.200 WAC. � ) <br />l�' <br />lr'; <br />r% <br />�� <br />