Laserfiche WebLink
i-- � t <br /> ' PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> � 3200 CEDAR STREET, EVERETT, WA 98201 <br /> I 425-257-8810-FAX 4?5-257-8857 <br /> I <br /> SITE ADDRESS PARCEL TAX I.D.# PERMiT p <br /> ; 5'L/o Gl� no� v� •Lgo 0 00 <br /> LEGAL LOiNO. BLOCK TRACT <br /> � DESC. <br /> � OWNER AODRESS / 21P PHONE p� <br /> �I JJ �K`� .Jr03 �Cy��OIC� /.U�'NQ <br /> R VP�c��,�es LLG, iwJ�sf wN�,. .�G V7Lcl� vr 97'L.-278(e <br /> • ! TENANTNAME CONTACTNAME HONE <br /> ', UN �ccu re� I Lh�s. ) 4z3- 4o8 <br /> i CONTRACTOR � � � ,����I G� ���� � <br /> ADDFcSS ZIP CONTR.LICENSEN <br /> i AFFc�e�J,�G/� f�6a�mP,v� Tc. 373� Sin�fli �v� <br /> : PHONE AFFc��r��F Cr= <br /> _ C42S) �n�- �i o72- �y e��'f"�, GG�ff� 9820/ <br /> � PROPOSED USE OF BUILDING Buildinp MeChanical Addition HEAT SOURCE <br /> I PERMIT �Combination � plumbing WORK R Atteralion D Eledric <br /> TYPE DCmO�itiOn Sign ITVPE D New Gas <br /> Sprinkler U RepaidMalm. I B O�her <br /> I CONTRACT PRICE OF WORK � � oU <br /> l✓ ZO U. CITY OF EVERETf LOCAL SALES TA%CODE IS�105 <br /> IWORK DESCRIPTION <br /> � ��.,.�ai,�,�.� oF ��C�,u� /f�«S� <br /> � <br /> PLUMBING MECHANICAL <br /> � NO. TYPE OF FIXTURE OR ITEM HO. TYPE OF FI%TURE OR ITEM <br /> I __ _ WATER CLOSET A/C—A/HANDLING UNITS <br /> BATHTUB FORCED AIR SYSTEMS <br /> i ___ LAVATC?f(WASH BASIN) HEAT PUMP <br /> ! SHOWER — <br /> ' � KITCHEN SINK 8 DISj'OSAL _ UNIT HEATERS <br /> : DISFiWASHER CLOTHES DRYER <br /> �� � LAUNDRY TRqY _ �NGE HOOD <br /> CLOTHES WASHER _ WATER HEATER <br /> � URINAL METAL FIREPLACE/STOVE <br /> : DRINKING FOUNTAIN _ FIREPLACE INSERT <br /> , FLOOR DRAIN _ GAS FIREPLACE <br /> � _. BACKFLOW PREVENTER ._ GAS RANGE <br /> SINK(SERVICE/BAR/MOP/ETC.) _ GAS PIPING <br /> � OTHER _ EXHAUSTFAN <br /> -- --- _ OTHER <br /> � — — -- -- i <br /> i <br /> 1 <br /> I HERE�Y CERITIFY THAT I HAVE READ AND E%AMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL � <br /> Ii PRO\9510N5 OF LAWS AND ORIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPE IFI I <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUMI2 TO GNE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OT ER <br /> STA7E OR LOCAL LAW REGULATING CONSTRUCTION 012 THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORI2ED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FJR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> � CONTR TORS W 1827 RCW AND 296.200 WAC. <br /> � � . / � , <br /> iSi ature f OwnedContractor/ uthonz d Agent / / � Dale `�S/�1f <br />