Laserfiche WebLink
� PERMIT APPLICA~r ION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> 425-257-8810-FAX 425-257-8857 <br /> SITE ADDRE S PARCEL TAX I.D.t PERMIT X <br /> � -u,�l � lo�( o/�( a� 6�305-o F <br /> LEGA LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER �O ��� , /E V �D� ZIP PHON <br /> ��� ���� /t��i`�c ��--� i,cT� qBz15 4-ZS �?ov 63? <br /> TENANTNAME CONTACTFOR PERMR PHONE <br /> I IU�UU �-� � 42S�7GG�n37 <br /> CONTRACTOR ��(� ADDRESS S ?j(j�J ZIp CONTR.LICENSE� <br /> PHONE ��S �j�� O � ?�'� <br /> O <br /> PROPOSED USE OF BUILDIN6 Build(ng Mechanical AdAltlon HEAT SOURCE <br /> � PERMIT B Combination R Plumbing WORK Alrorauon D Etecbc <br /> TYPE D Demolitlon D Sign TYFE D Gu <br /> U Sprinkler epa�rnda�nt. D omx <br /> CONTRACT PRICE OF WO 1 ' 1�v Il n CITY OF EVERETf LOCHL 3ALES TAl(CODE q�106 <br /> WORK DESCRI T10N { v <br /> �an�p c�� �k.1S� W GD D Gt9 ! � D o u.1 S /2�G�c-� � <br /> V i ►J'� LC 'D6 u gL� ���'� � Iu p ow s <br /> PLUMBING MECHANICAL <br /> NO. TYPE OP FIXTURE OR ITEM NO. TYPE OF FIXiURE OR ITEM <br /> _ WATER CLOSET(TOILET) A/C—A/HANDLING UNITS <br /> BATHTUB FORCED AIR SYSTEMS <br /> _ LAVATORY(WASH BASIN) HEAT PUMP <br /> SHOWER UNIT HEATERS <br /> = KITCHEN SINK 8 DISPOSAL �' ` � = CLOTHES DRYER � � <br /> DISHWASHER �v 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/BARIMOP/ETC.) EXHAUST FAN <br /> OTHER OTHER <br /> I HEREBY CERITIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br /> PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WMETHER SPECIFIED MEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br /> STATE OR IOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OP CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR W APPIICATION IS MADE AND I COMPLY WITH THE STATE <br /> CO C ORS 18 _ ND 296.200 WAC. <br /> �", �'., ���Z� L �,�� <br /> Signature of Owned ontracmdAuthorized Agent ate <br /> DEBIT 8�CREDIT CARDS ARE NOT ACCEPTED <br />