Laserfiche WebLink
PERiVIIT APPLICATION <br /> CITY OF EVERETT PEnMIT SERVICES <br /> 3200 CEDP.R STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8F357 <br /> SITE ADORESS PARC[L TAX I.D.# I PERMiT a <br /> � ' <br /> 'L i %/ 'C. <br /> LEGAL LOTNO. BLOCK TRACT I � I ' <br /> DESC. j . aw� � �f(�,'C f'1�A�(Yl� <br /> OW ER ADDRESS ZIP PHONE <br /> �`�"� (z� � �-� L���� c��u-.�,��� q��� � �a����� � i� <br /> TENANI'NAME �� I CONTACT NAME PNON[ <br /> (��Y r1o.L= <br /> CONTRACTOR / ADDRESS ZIP CONTR.LICENSE k <br /> PR�(�i(l��;C W h i�� 1(Y:w;�i i-p' 12,1���r����(�.� �lll�C.. �j�i�l}�tl �-�- l0�.�\4 <br /> PHONE <br /> 3�e� �S�• �l�a� �t�c q�(3 ma2�5��.\� W� 1�7� <br /> PROPOSED USE OF BUILDING [3Uildinr� ("� MeChaniCal � Atldition HEAT SOURCE <br /> �Z�C�"�<,�r W�.��1 pv� I PERMIT R�.�[ Combinalion �� Plumbing WORI< Alteralion Q Electric <br /> `O� �I S� � TYPE u DFmolitiOn �� Sign TYPE New j� Gas <br /> L� Sprinklef RepairRdainL U Olher � <br /> CONTRACT PR�CE OF WORK f ��O ,Ot,� CITY OF EYERETT LOCAL SALES TAX CODE IS 3105 <br /> `U —�— <br /> WORK�ESCRIPTION �Q�`ALC �}Cl�-`1'�4 �C_11�ih�v�� lv���.� �uC��h �hl:�� j1rC_ •'10`C <br /> [� � / � ` I <br /> i Lc'c.c_ `c.—�!li�1C W��C� SPcMC �7�u ��m�3n '�i��.c.Y � �2--Z.e.(J� �A-MC �,*ey�� "t <br /> i.��c���-- tti`7 ��c;�l-�,a� . �P�n;v- �3� N•q�• _ "'�t.` la� . �C���1�L �,�; ,�<.��t5 <br /> PLUMBING MECHANICAL <br /> ; NO. NPE OF FIXTURE OR ITEM NO. 1YPE C1F FIXTURE OR ITEM <br /> I' WATERCLOSET _ A/C—A/HANDLINGUNITS <br /> �� BATHTUB _ FORCED AIR SYSTEMS <br /> LAVATORY(WASH BASIN) __ HcAT PUMP <br /> � SHOWER UNIT HEATERS <br /> KITCNEN SINK 8 DISPOSAL _ CLOTHES DRYER <br /> � _ DISHWASHER _ RANGE HOOD <br /> LAUNDRY TRAY WATER HEATER <br /> CLOTHES WASHER METAL FIREPLACE/STOVE <br /> i URINAL FIREPLACE INSERT <br /> �, DRINKiNG FOUNTAW � GAS FIREPLACE <br /> � FLOOR DRAW _ 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 AfJD EXAMINED THIS APPLICATION AND NNOW THE SAME TO BE TRUE AND COFRECT. ALL <br /> PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS NPE OF WORK WILL BE COMPLIED WIThI WHETHER SPECIFIED HEREIN OP. <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOL4TE OR CANCEL THE PROVISION OF ANY OTHEfl <br /> STATE OR LOCAL�W REGULATING CONSTRUCTION OR THE PERFOAh1ANCE OF CONSTRUCTION. THAT I AM AUTHOPIZED B'!THE <br /> qWNER OF THIS PROPERTY TO PERFORM TNE WORK FOR WHICH APPLICATION IS hIA�E AND I COtAPLY WITH THE STATE <br /> CONT AC�OFS LAW 1827 RGW AND 296200 WAC. <br /> 9� ��� 9 �l�1 au c� � c� <br /> Si n Wre ol wner/Contracto orized A enl ate <br />