Laserfiche WebLink
� <br />� <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERElT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 <br />a,c,t.Y� �.,,_ e4•,ck. <br />SITE ADDRESS S µ-� ��Z PARCEL TAX I.D. M PERMI7 a <br />2 Z l S6 6v�v*.,� laa.11 W� I oo y- BoZo - t ao l- 20�o I B oac�Cn -LY6 <br />LEG4 LOTNO. <br />oecc. (Z, <br />OWNER <br />vir4c� �c:ol� <br />U <br />TENANTNAME <br />SylUa�.v� Li.a,rrw <br />CONTRACTOR 'r � p <br />PHONE�� h /// <br />-Ki' .�si <br />PROPOSED USE OF BUILDING <br />b��- <br />CONTRACT PRICE OF WORK ' <br />BLOCK <br />IZ <br />�221 <br />7RACT <br />1 vuwci � add.idi o�� Di u i)ok I, Csu. �I�.u.t' T- �) <br />ADDHESS 21P PHONE <br />�ut� 1'�'�e�,li- l,t�a� cSE B-3 q8do8 `�-�3b5-lo05 <br />CONTACTNAME <br />Cu�W V��i �w�ppi �CoN.t�.cU. <br />ADDREZSS <br />a3ias s5'���/S� <br />/'s-o��// 96033 <br />PERMIT <br />TYPE <br />%0� 000 <br />�j Building <br />r-r Combination <br />r� Demolilion <br />D Sprinkler <br />WORK DESCRIPTION <br />dt,�u.p�i iz'OVI. `� �vitrGuqi'Gu.�� S�t,(.a�Y W�,(-� , <br />� PGCt,p(l�- f�rti u- � U <br />NO. � TYPE OF FIXTURE OR ITEM <br />WATER CLOSET <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWEA <br />KITCHEN SINK R DISPOSAL <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTER <br />SINK (SERVICE/BAR/MOP/ETC.) <br />OTHEFi <br />BMechanical <br />Plumbing <br />D Sign <br />PHONE <br />yas-��o-�'wc <br />ZIP CONTR. UCENSt N <br />Addilion <br />Alteration <br />New <br />Repair/Maint. <br />HEATSOURCE <br />e�eccrio <br />Gas <br />OIhBr <br />CITY OF EVERETT LOCAL SALES TAX COOE IS 3105 <br />IX.C�d � 11.LU/' D rciLLS ��Wt.v� rc� "�vA.tit��-Ciidi4 <br />.� <br />NO. I TYPE OF FIXTUHE OR ITEM <br />A/C - AlHANDLING UNITS <br />FORCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT HEATERS <br />CLOTHES DRYER <br />RANGE HOOD <br />WATER HEATER <br />METAL FIREPLACE/STOVE <br />FIREPLACE INSERT <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUSTFAN <br />OTHER <br />I HEi;EBY CERITIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LSWS ANO ORIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PFiESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br />STATE OR IOCAI lAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTFUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 FiCW AND 296.200 WAC. <br />Signalure ol Owner/Contractor/Authorized Agent Date � <br />IL <br />