Laserfiche WebLink
� <br /> PERMIT APPLICATIt�N <br /> CITY OF EVERETT R�RMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 96201, 425-257-8810 <br /> SITE ADDRESS PARCEL TAX I.D.R P RMIT N <br /> 222G Lon�anR-o A�E. voga9!- `��� -oi5 - a� lo� -O/ <br /> LEGAL LOT NO. BLOCK TRACY n <br /> DESC. E', %z -Lo75 /91U �f7` !'L9 � Q/� ��-f� <br /> OWNER ADDRESS PHONE <br /> /�Rc.�7JE s//�+p/�2 i 222� L6 M BA•r.0 <br /> TENANT NAME CONTACT NAME � PHONE <br /> M/�/REL MAu1�` 36a i �SZ - SGo� <br /> CONTRACTOR ADDRESS � CQNTR. UCENSE# <br /> h1qLa y �'QNsTzuc rraJ ? <br /> PHONE ��{Jz/ %�Nn Adr. �1.G�� I �IALQ <br /> .�Ga- �sz- s�ai C MSUL. UA . ��z �i ; vc- a�»� <br /> PROPOSED USE OF BUILDING 9uilding � Mechanical Addition HEAT SOURCE <br /> t klSTi�.Il� PERMIT � Combination Plumbing WORK � Alteration � Eledric <br /> TYPE �emolilion Sign TYPE New Gas <br /> s •F ,e�$/O�J�� Sprinklef Repair/Maint. Other <br /> CONTRACT PRICE OF WORK ,� 6 7 S� °�' CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> WORKDESCRIPTION T. ��P�AC� . �X�S�/�J4 �Q$7- }� ��E2 fdUNQ�f TU� <br /> /O <br /> G1�Th ,U� Pau2r�J ca�c2E7cr' F"eu�aATia�J <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF FIXTURE OR IT�M N0. 'IYPE OF FIXTURE OR ITEM <br /> WATER CLOSET rVC-A/HANDLING UNITS <br /> BATHTUB FORCED AIR SYSTEMS <br /> LAVATORY(WASH BASIN) _ HEAT PUMP <br /> SHOWER UNIT HEATERS <br /> K�TCHEN SINK& DISPOSAL CLOTHES�RYER <br /> DISHWASHER RANGE HOOD <br /> LAUNDRY TRAY WATER HEATER <br /> CLOTHES WASHER METAL FIREPLACE/STOVE <br /> � URINAL FIREPLACE INSERT <br /> DRINKING FOUNTAIN GAS FIREPLACE <br /> FLOOR DRAI�' GAS RANGE <br /> BACKFLOW PREVEN�ER GAS P�PING <br /> SINK(SERVICE/BAR/MOP/ETC.) _ EXHAUST FAN <br /> OTHER OTHER <br /> I HEREBY CERITIFV THAT I HAVE READ AND EXAMINED THIS APPLICATIUN AND KNOW THE SAME TO BE TPUE AND CORRECT. ALL <br /> PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMP�IED WITH VJHETHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT OOES NOT PRESUME TO GIVE AUTHORIIY TO VIOL4TE OH CANCEL THE PRO\'ISION OF ANY OTHER <br /> STATE OR LOCAL LAW REGUL4TING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORI2ED BY THE <br /> OWNER OF THIS PROPERIY TO PEflFOPM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 1827 RCW AND 296.200 WAC. <br /> I ' �� 9 aa ��/ <br /> Signalure o(Own dContractod ulhonzed Agent Date �/ <br /> Z <br />