Laserfiche WebLink
PERIVIIT APPLICATIOIV <br />CITY OF EVERETf PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, '✓JA 98201 <br />425-257-6810 — FAX 425-257-8857 <br />SI7E ADDRESS ' <br />�� � L. � r� cl4 6l y� <br />LEGAI LOT NO. BLOCK TRACT <br />DESC. <br />PARCEL TAX I.D. # <br />-000 -oao <br />!—/6._O <br />PE � MIT k <br />I'i �'j/ - <br />VVYIVCH MUUI'1CJJ GIY YOVryC LI l� � <br />� u e re �,t I-�-o v s i n C� (� „� �-c� . 3 i o"�- Co I b y Gi $ 3 0 � 5 O I 51� C�� <br />TENANT NAfdE C07JTACT NAME PHONE I <br />�NA j�i 1� I.,o�-��� s u�� -5ol-Si�t�l j <br />CONTRACTOR �'� a ADDRESS 21P CONTR. LICENSE R I <br />� � <br />PHONE ! <br />PROPOSF_D USE UF BUILDING <br />� F c�, R D "i «P <br />Building echanic <br />PEqMIT R Combinalion Plumbing <br />TYPE D Demoli�ion Sign <br />u Sprinkler (u of heads) <br />CONTRACT PRICE OF WORK � �� � <br />Addition HEATSOURCE <br />Alteration Electric <br />New as <br />RepaidMainL Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />WORK DESCRIPTION <br />M c�,� r n��Z �' Ex � S'S-i r�G �� w �... c a �.�,2 �.�-g v�n C� <br />NO. I TYPE OF FIXTURE OR ITEM <br />WATER CLOSET (TOII_ET) <br />8ATliTUB <br />LAVATORY (WASH RASIN� <br />SHOWER <br />KITCH[N SINK 8 DISPOSAL <br />DISHWASfiER <br />LAUNDRYTRAY <br />CLOTI�ES WASH[F <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENT[R <br />SINK (SERVICE/BAR/MOP/ETC.) <br />OTHER <br />NO. � TYPE OF FIXTURE OR ITEM <br />A/C - A/HANDLING UNITS <br />FORCED AIR SYSTEMS <br />HEAT PUDAP <br />UNIT HEATERS <br />CLOTHcS DRYER 1'h� �`e- <br />RANGE HOOD 1�-p�� '"� <br />_ WATER HEATER P-s-p �"`"�- <br />_ METAL FIREPLACE/STOVE <br />FiREPLACE INSERT <br />GAS FIREPLACc <br />GAS RANGE <br />ti GAS PIPING <br />EXHAUSTFAN <br />OTHER <br />I HERE�Y CERITIFY THAT ! HAVE READ AND EXAMINED THIS APpLICATION ANC KNOW ThIE SAIdE TO BE TRUE AND CORHECT. ALL <br />�f10VISIONS OF LAWS AND OHIUINACES GOV[RNING THIS NPE OF WORK WILL �E COMPLIED WITH WHEfHGR SPEGIFIED HEREIN OR <br />NOT. THE GRANTING UF A PERMIT DOC-S NOT PRESUME TO GIVE AUTHORITY TO VIOIATE OH CANCEL THE PROVISION OF ANY OTHER <br />STATE OR LOCAL LP.W R[GULATING CONSTRUCTION C1R THE P[RPOR61ANCE OF CONSTRUCTION. THAT I AM AUTHORIZED 6Y THE <br />OWNER OF THIS PROPERTY TU P[RPOflh1 THF WORK FOR WHICH AFPLICATION IS IdADE AIJD I COt.1PLY bVITH THE STATE <br />CONTF�4CTORS LAW 18.<' RCW AND 296200 WAC. <br />.� ��.A� ,u .,. . .� %- / h � <br />