Laserfiche WebLink
P`�RMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810- FAX 425-257-8857 <br /> SITEADDRESS al �a �FFf'�R50/J 1''L pARCELTAXI.D.# PERA417» <br /> r E R 6 _id7�`� '� "' C�� �O - j�J <br /> LEGAL LOTNO. BLOCK TRACT <br /> DESC. -� � -.- <br /> i ,. � ,_. 'r ,, �_`�) > <br /> OWNER ; ADDRESS ZIP PHONE �L.�ZS� <br /> .�E�.rv� �� 4 -- 1�3� S'L . S� C�er�� � WA 9 �2og y38-117_3 <br /> TENANT NAIA[ CONTACT FOR PERMIT PNONE <br /> �o� v„ q2s - 438 - 11 Z.3 <br /> CONTRACTOR ��N��� COnS, ADDRE55 J IIP CUNTR.LICENSE# <br /> II iasr�� id � P� w <br /> P ONE ��HAMS(rC973133 <br /> ��,/R_ /.,�R� ���ee� Tr �r��r �ik�o�, <br /> PROPOSED USE OF SUILOING I�S Building I-"; MechaniCal Addition I HEAT SOURCE <br /> PERMIT FI---((' COmbinatiOn �_� Plumbing WORK Alteratlon �Electnc <br /> �eC� �-4�'�a+v� ("�� 1YPE �J Dem01iti0n LJ Sign TYPE New Gas <br /> IS G ( i�Y 65�dE.�k�: u Spfinkler RepairlMaint Other <br /> CONTRACT PRICE OF WORK CIIY OF EVERi:7T LOCAL SALES TFU(CODE IS 3105 <br /> WORK DESCRIPTION � � <br /> �ct`�eb. c�� ,.e��c-+�'S. �e�au� , �:� Y � <br /> j Y � � <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> WATER CLOSET(TOILET) _ A/C-A/HANDLING UNITS <br /> BATHTUB FORCED AIR SYSTEMS <br /> LAVATORY(WASH BASIN) _ HEAT PUMP <br /> SViOWER UNIT HEATERS <br /> KITCH[N SINK& DISPOSAL CLOTHES DRYER <br /> DISHWASHER RANGE HOOD <br /> LAUNDRY TRAY _ WATER HEATER <br /> CLOTHES WASHER NiETAL FIREPLACE/STOVE <br /> URINAL FIREPLACE INSERT <br /> DRINKING FOUNTAIN GAS FIREPIACE <br /> FLOOR DRAIN GAS RANGE <br /> BACKFLOW PREVENTER GAS PIPING <br /> SINK(SERVICE/BAWMOP/ETC.) _ EXHAUST FAN <br /> OTHER OTHER <br /> � I HEREBV CERITIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SFME TO 6E TRUE ANC CORRECT. ALL <br /> PROVISIONS OF IAWS AND ORIDINACES GOVERNING l'NIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR �I <br /> ' NOT. THE uRANTING OF A PERMIT DOES NOT PRESUh1E TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br /> STATE OR LOCAL iAW REGULATING CONSTRUCTION OR THE PERFORMAK^.E OF CONSTRUCTION. THAT I AM AUTHORIZED Bl'THE 'I <br /> � T PERFORh1 THE WORK FOR WHICH APPLICA'�!ON IS MADE AND I COMFLY WITH 7HE STAT° <br /> . OWNEROFTHISPROPERTY O <br /> I CONTRACTORS LA 7827 RCW AND 296200 WAC. I <br /> ��"1 � /r����/ ���� II <br /> Signature ef OwnedC ntrac:or/Authonzed Agent Date O0 � �/Z� � <br /> l I <br /> DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED __j <br />