Laserfiche WebLink
( <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810- FAX 425-257-8857 <br /> SITE ADDRESS PARC�L TAX I.D.# PERMIT tt <br /> �v Sfre� ��'�c� DS-D,� 9 <br /> LEGAL LOTNO. BLOCK TRACT ' <br /> DESC. — " _ <br /> OWNER ADDRESS <br /> ���na-H�o� i C�.��- c� �P�{ ���., Po�f�atid ���,�-�tHNz <br /> TENANTNAME CONTACTFORPERMIT —� PHONE <br /> Ms� � Sa� M,ll�- CY�>g�s-aio� <br /> CONTRACTOR A�DRESS Zip CONTR.LICENSE# <br /> Uv�ive,v�sa ( M�c�av�i ca � �dao1 �,J� llrn,�s 1� <br /> _�vis) �6Ss�-9ret) Iz-edwt�.c� WA- ��60SZ UNIVEM513Z�TF <br /> PROPOSED USE OF BUILDING Building r�echanical Addition HEAT SOURCE <br /> /�� 1' I PERMIT RI--[ Combinalion��1( P��'lumbing WORK R �jlion n�-( _Eleciric <br /> �tY1Ge/t�AV��e NPE �.j Demolition U Sign ITYPE �YNew I �"�as <br /> L� Sprinkler r� Repair/MainL LJ o�her <br /> I CONTRACT PRICE OF WORK `�+ D� ,yy� CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> ) C/(/ <br /> �� WORKDESCRIPTION � {-� Wft <br /> � as5cx.�af.eo( �''^s�lYi��af-�mn o� Z rooF-fap 9as e(ecfv��c �.{�f�ay� uti� <br /> u�i-worl�t� di.�use�r's a�cl ce,.il-v-ol sys�-�, 3 yas vti,f- I�ea <br /> � �f ���sf ��,5 . �a5 p�p,�y +� -���� apP��a�,��. <br /> ?LUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> _ WATERCLOSET _ q/C-A/HANDLINGUNITS <br /> _ BATHTUB L FORCED AIR SYSTEMS <br /> _ LAVATORY(WqSH BASIN) _ HEAT PUMP <br /> _ SHOWER ,� UNIT HEATERS <br /> _ KITCHEN SINK&GISPOSAL _ CLOTHES DRYER <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 DRAIN GAS RANGE <br /> _ BACKFLOW PREVENTER � GAS PIPING <br /> __ SINK(SERVICE/BAR/MOP/ETC.) � EXHAUST FAN <br /> _ OTHER _ OTHER <br /> I HEREBY CERITIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AN�KNOW THE SAME TO 8E TRUE A�JD CORRECT. ALL <br /> PROVISIONS OF LAW9 �ND ORIDINACES GOVERNING THIS NPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIV[AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br /> STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. 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 /> CONTRAC . .2 RCWAND296200WAC. <br /> U �� ay �l Z <br /> S� nature of Owner/Contractor/Authorized Agent ate ` <br /> , DEBIT& CREDIT CARDS ARE NOT ACCEPTED ,/L) <br />