Laserfiche WebLink
� <br />`� <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR S7REET, EVERETT, WA 98�01 <br />425-257-8810 - FAX 425-257-8657 <br />SITE ADDRESS <br />3 6/ _ v ✓� <br />LEGA LOTNO. BLOCK <br />oesc. 26 �7 r� � / 2 <br />OWNER <br />nff"2i5Tir7� �CMcrT� �ERri� <br />TENANT NAME <br />��i.�/E � �i 4w.v. <br />coriraacroa <br />PHONE � /� <br />� <br />PROPOSED USE OF BUILpING <br />CONTRACT PRICE OF WORK <br />PARCEL TAX I.D. k <br />-,���_��< <br />PERMIT H <br />3ozo�-o �,� <br />TRACT <br />kivA-vs G/r.sT.f�vvi �o.� % tv�'P�`�l�Oc 3/�,lr-,c 3 y <br />ROD SS ZIP PHONE � <br />0 <br />CONTA�T NAME <br />AD6RESS <br />Bu�lding Mechanical <br />PERMIT R Combination R Plumbing <br />TYPE D Demolilion � Sign <br />U Sprinkler <br />Y11: <br />PHONE <br />CONT9, LICENSE p <br />Addilion <br />WORK Altaratlon <br />TYPE New <br />Repair/Maint. <br />HEAT SOURCIc <br />Electrir, <br />Gas <br />Olher <br />CITY OF EVERETT LOCAL SALES TAY, CODE IS 3105 <br />WORK DESCRIPTION <br />L�ft/�iv� �tAS'SiF�c..4-T�o.v F.Qo.•.+ �oori�� ��5�' T Si�uGc6�icy <br />N0. � SYPE OF FIXTURE OR ITEM <br />WATER CLOSET <br />BAThiTUB <br />_ LAVATORY (WASH BASI;�) <br />_ SHOWER <br />KITCHEN SINK.B D;SFOSAL <br />�!SHWASHER <br />LAUPJDRY TRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKIIJG FCUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTER <br />SINK (SERVICE/BAPJMOP;cTC.I <br />OTHER <br />NO. � TYpE OF FIXTURE OR ITEM <br />/�/l:—A/hiANULINCi VNIIS <br />_ FORCED AIR SYSTEMS <br />_ HEAT PUMP <br />_ UNIT HEATERS <br />_ CLCTHES DRYER <br />RANGEHOOD <br />WATER HEATER <br />fv1ETAL FIREPLACE/STOVE <br />_ FIREPLACE INSER? <br />GAS FIREPLACE <br />_ 3AS RANGE <br />GAS FIPING <br />EXHAUST FAIJ <br />OTHER <br />I HER[BY �ERITIFY THAT I HAVE READ AND [XAh71NED THIS APP! ICATION ANQ KNUW THE SAME 70 BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS i�ND OFIDINACES GOVERNING THIS TYPE OF WORK WIIL BE COMPLIE� WITH WHEfHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUNE TO GIVE AUTHORIT'f TO VIOLATE OR CANC�� THE PROVISIOIJ OF AP!Y OTHER <br />ST.4TE CR LOCAL LAW FF.GULATING CCNSTRUCTIOIv OR THE PERFORMANCE OF CONSTRUCTION. THAT i AM AUTHORiZED BY THE <br />OWIJER OF THIS PROPER7'/ TO PERFORM TNE �JJORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONi RACTORS LAW 182'i RCW AN� 29E200 ih'AC. <br />'�� <br />