Laserfiche WebLink
; PE aMIT P►F�PLlGAT14_ : � <br /> � CITY OF EVERETi PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 ; <br /> SITE ADDRESS PARCEL TAX I.D.k P��•�iT= li <br /> �.�f/- 1 <br /> �2-j� ..�Q kSG� 11 G�.- t��'"� y5✓Cl.S�Ull / t� U �J 7L�'� �/� <br /> LEGA LOTNO. BLOCK TRACT <br /> I DESC. i <br /> I OWNER ADDRESS ZIP PHONE I <br /> , 1 '/zS�^'o��-rFi;r' i <br /> �w r� 1� G Sk� I ` �" `� �:� � /\...�_. � �W-{-t- z6 Z .s <br /> �L L l i� r l .l: � � � c^ <br /> TENANT NAhiE CONTACT NAME PHONE <br /> '\ � I I `� <br /> �d�l � `Slfi���.�� 'T'�rtJ 7 ) � - /���' 1_ys � <br /> CONTRACTOR��'"' ADDRESS ZIP CONTR. LICENSE# I <br /> �nr,�'✓I f� � G��:i'�Y ✓ �h� � Ih��l l �'���f��� ��_ � " I <br /> �J � / <br /> PHONE �i- --�i ,�? •��" <� '�UNr9L�FG�-!�/I� I <br /> ��,_'�._ ,, ., , - , ��1 L��n✓� �,J�c•c� W` �, � <br /> , � <br /> PROFOSED USE OF BUILDING ` � Building (� Mechanical Addition HE T SOUR E I <br /> _ ��� PERMIT Combination �_� Plumbing WORK RL-(. Alteration EI vic <br /> ���-' `" � - I TYPF � Demolition �j Sign 7YPE [,�j, New as <br /> /.� i�`' '��� Sprinkler LJ RepaintAaim. mer <br /> CONTRACT PRICE OF WORK �� I •7 � `��ZSf� CITY OF EVERETT LOCAL SALES TAR CO�E IS 3105 — <br /> C � <br /> WORK�[SCRIPTION <br /> I ,}I��. �j 1 ( � J r- <br /> I ���✓� � 1Y t-:L'I` V�G�I.J �J'.�G�'�l �.�/�L G' 1'.JU � c'` rti !',� � \ D( ��.'-��I <br /> � � i <br /> �I PLUMBING MECHANICAL <br /> � NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE 7R ITEM <br /> WATER CLOSET A/C-A/HANDLING UNITS <br /> BATHTUB FORCED AIR SYSTEMS <br /> LAVATORY (WASH BASIN) _ HEAT PUMP <br /> SHOWER UNIT HEATERS <br /> KITCHEN SINK& DISPOSAL CLOTHES DRYER <br /> DISHWASHER RANGE HOOD <br /> LAUNDRY TRAY WATER HEATER <br /> CLOTHES WASHER METAL FIREPUICE/STOVE <br /> � URINA.. FIREPLACE INSERT i <br /> DRINKING FOUNTAI.'V GAS FIREPLACE �� <br /> FLOOR DRAIN GAS RANGE �� <br /> BACKFLOW PFEVENTER GAS PIPWG <br /> SINK(SERVICE/BAR/MOP/ETC.) _ EXHAUST FAN �, <br /> OTHER _ OTHER__ ��. <br /> I HEREBV CERITIFY'HAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAL1E TO dE TRUE A�JD CORFECT. ALL <br /> PI70VISIONS OF LAWS AN�OFIDINAC[S GOVERNING THIS TYPE OF WORK WILL BE COMFLIED INITH WHETHEF SPECIFIcD HEREIN OF <br /> ;dOT. THE GF7ANTING OF A PEFMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOUTE OR CANCEL THE PPOVISION OF ANY OTHER <br /> STATE OR LOCAL LAW REGUL%1TI G CONSTRUCTION OR THE PERFORMANCE OF CONSTRIJC710�J. THAT I AM AUTHORIZED BY THE <br /> OWNER CF THIS PRO ERN TO P �FFORM THE'NOflK fOR WHICH APPLIC TION IS 6L1DE AND I COM1IP�Y'NITH THE STATE � <br /> CO�IIRACTOFS LA 27 RCW D 296.200 4VAC. � <br /> � t <br /> '�_� !� !u �, <br /> SignaWre ol Owner n raclor/Authorized Agenl D e <br /> - --- -- — ..__ --- — -- -- � <br />