Laserfiche WebLink
� <br />� <br />SITE ADDRE55p <br />�Q i1 <br />LEGA LOT N0. <br />DESC. /V f � <br />OWNER <br />�_--.��5 <br />TENANT NAME <br />CONTRACTOR <br />PHONE <br />PE� .MIT APPLICATIO► . �'`��' <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 <br />�+A�� � 22 <br />PARCEL TAX I.D. N PE�y 7 M <br />s r� r o o s � 8800 �o l�oc� _ C,��iG� <br />� BLOCK <br />S <br />I 3S�a G K C; �/y �..,/v N. <br />ICONTACT NAME PHONE <br />c%s :�y.-..», �=s� 3�-9r�s <br />ADDRESS ZIP CONTR. UCENSE M <br />/nJ. (r.�.✓Jr'/h�h -lonST/.tii��,� I�Ml,3� OG 7 ZZ Z s�. h! l�J�TN6C,�c�saN <br />►;7� <br />[7 <br />PHOPOSED USE OF BUILDING <br />E✓�,.rr �ii �rqy �<ti� <br />Building Mechanical <br />PERMIT �Combinalion � Plumbing <br />7YPE Demolilion Sign <br />Sprinkler <br />CONTRACT PRICE OF WORK �/p p; p, "' <br />WORK DESCRIPTION , '�p ,L �S6 �1 5��'y�P <br />Gw�.sTr-c.� %o�ti � T 9� <br />NO. I TVPE OF FlXTURE OR REM <br />WATER C�OSET <br />BATHTUB <br />LAVATOAY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 DISPOSAL <br />UISHWASHER <br />LAUNDRY TRAY <br />CLOTHES WASHER <br />UFINAL <br />DRINKING FOUNTAIN <br />FLOOF DRAIN <br />BACKFLOW PREVENTER <br />SINK (SERVICElBAR/MOP/ETC.) <br />OTHER <br />Additian <br />WORK Alteration <br />TYPE New <br />Repair/Meint. <br />HEATSOURCE <br />Electric <br />Gas <br />Other <br />CITY OF EVERETT LOCAL SALES TAJC CODE IS 3105 <br />�� hl.'�wcG <br />NO. � TYPE OF FlXTURE OR ITEM <br />_ A/C—FVHANDLINGUNITS <br />_L FORCED AIR SYSTEMS <br />_ HEAT PUMP <br />_ UNIT HEATERS <br />� CLOTHES DRYER <br />� RANGE HOOD <br />� WATER HEATER <br />METAL FIREPLACE/STOVE <br />� FIREPLACE INSERT/ c�,¢S <br />_ GAS FIREPLACE <br />� GAS RANGE <br />GAS PIPING <br />� EXHAUSTFAN <br />_ OTHER <br />I HEREB'f CERITIFY THAT I HAVE READ AN� EXAMINED THIS APPUCATION AND KNOW iHE SAME TO BE TAUE AND CORRE�T. ALL <br />' PROVISIONS OF LiWS AND ORIDINACES GOVEfiNING THIS IYPE OF WORK WILL BE COMPl1ED WITH WHETHER SPECIFIED HEREIN OR <br />� NOT. THE GRANTING OF A PERMIT DOES NOT PFiESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIC`N OF ANY OTHEA <br />� ST:.Tc OR LOCAL LAW FEGULATING CONSTAUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFOqM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACwFORS LAW 1827 RCW AND 296.200 WAC. , <br />I /7 <br />