Laserfiche WebLink
PLF�MIT APPLICATIC:.J <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR ST�;EET, EVERE'I7, WA 98201 <br /> 425-257-8�10— FAX 425-257-885,' <br /> SITE ADDRESS � pARCEL TAX I.D.k <br /> PERMIT <br /> //a 3 � �� :1 G.�e� �c�'� ��-3 <br /> IEGA L07N0. BLOCK TRACT <br /> �ESC. <br /> OWNER pDORESS <br /> ���� � � ZIP PHONE <br /> i�( <br /> TENANTNAME I CONTACTNAME <br /> PHONE <br /> CONTRACTOR ADORESS <br /> � //L'1 � ZIP CONTR.LICENSE q <br /> PHONE �JL( 7��/'� t/GLU�C� <br /> PROPOSED USE OF BUILDING I BUlldifl9 D Mechanical <br /> PERMIT � Combination U PlUrtlbi� Addition HEAT SOURCE <br /> TYPE 9 W�RK Alleralion Q Electric <br /> Demolilion U Sign "�YPE New �,J Gas <br /> SOrinkl�r RepaidMaint. L� Olher <br /> CONTRACT PRICE OF WORK r �Q� CITY OF EVERETf LOCAL SALES TAX COOE IS 3105 <br /> WORK OESCqIPTION <br /> i PLUMBING <br /> MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FI):TURE OR ITEM <br /> i _ WATER CLOSET <br /> ' _ BATHTUB — aL—aHANDLING UNITS <br /> _ LAVATORY(WASH BASIN) _ FORCED AIR SYSTEMS <br /> � _ SHOWER =_ HEAT PUMP <br /> _ KITCHEN SINK 8 DISPOSAL — UNIT HEATERS <br /> _ DISHWASHER _ CLOTHES DRYER <br /> � _ LAUNDRY TRAY _ RANGE HOOD <br /> 1 _ CLOTHES WASHER — `�'�ATER HEATER <br /> _ URINAL — ME7AL FIREPLACE/STOVE <br /> _ DRINKING FOUNTAIN FIREPLACE INSERT <br /> ' _ FLOOR DRAIN � GAS FIREPLACE <br /> _ BACKFLOW PREVENTER GAS RANGE <br /> _ SINK(SERVICE/8AR/MOP/ETC.) � GAS PIpWG <br /> _ OTHER __ EXHAUSTFAN <br /> _ OTHEFl <br /> I HEREBY CERITIFY THAT I HAVE READ AND EXAPdINED THIS APPLICATION AND KNOIV 7HE SAME TO BE TRUE AND COARECT. ALL <br /> PROVISIONS OF I_P,WS AND ORIDINACES GOVERNING THIS NPE OF WGRK WILL BE COMFLIED WITH WHETHER SPECIFIED HEREIN OF <br /> N07. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br /> STATE OR LOCAL LAW REGULATING CONS7RUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PEfiFORM THE WORK FOR WHICH APPLICATION IS MADE A.ND I COMPLY WITH THE STATE <br /> CONTRAC70RS LAW 1827 RCW A�ND 7296.200 WAC. <br /> t�n') � -r/ls�/ �fLv-[.�/ �'� -��� <br /> S y^�awre ot vmedContractodAuthonzed Agent Date <br />