Laserfiche WebLink
� <br />� <br />SITE ADDRESS <br />LOT N0. <br />► <br />� 's <br />���RIVIIT APPLICAT�'�JN <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 <br />OLOCK <br />�•I_1cLN�fif_F:il17E,; <br />TENANTNAME CONTACTNAME <br />VI��d2LTC ���ZC <br />CONTRACTOR � AODRESS <br />tvc�2�-zz,� �c— �F��T ��C. I��l E. t�(n�� Vl��b.�. <br />PHONE <br />f�l-z�� 2sZ-3i�� - k�• `I'd�-5o8-07�,�. <br />PROPOSEO USE OF BUILDING <br />D�`� C4�zc ��-f.�rc-2 <br />Buildfng echanic <br />PEFMIT R Combination Plumbing <br />TYPE D Demolition Sign <br />D Sprinkler <br />CONTRACT PRICE OF WORK /�� �, <br />WORK DESCRIPTION <br />lus�rtc.� ( z� 3 -c� l���f`. <br />N0. I TYPE OF FIXTUqE OR ITEM <br />WATER CLOSET <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK & DISPOSP.L <br />DISHWASHER <br />LAUNDRY TFiAY <br />CLOI'HES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTER <br />SINK (SERVICE/BAR/MOP/ETC.) <br />OTHER <br />PERMIT # <br />PHONE <br />IP CONTR. UCENSE A <br />��z�� c�r��oz�� <br />ditton <br />WORK Alleration <br />7YPE New <br />Repair/Maint. <br />HEATSOURCE <br />EI tric <br />Ges <br />Olher <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />�,� �k�sz�� a� <br />NO. � TYPE OF FIXTURE OR ITEM <br />AIC —A/HANDLING 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 />EXHAUST FAN <br />I HEREBY CERITIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORFECT. ALL <br />PROVISIONS OF LAWS AND ORIDINACES GOVERN�NG THIS TYPE OF WORK WII.L BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANT�NG OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY i0 VIOLATE OR CANCELTHE PROVISION OF ANY OTHER <br />STAT� OR LOCAL lAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />CONTRACj'O�S LAW P8.2 TMCW D 2�6 2 0 W CORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />v v <br />Mo�o�-003 <br />