Laserfiche WebLink
� PCRMIT APPLICATI�.V <br /> CITY OF EVERET�T PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810— FAX 425-257-8857 <br /> bo3� -o <br /> SITE ADDRESS PARCEL TAX I.D.A PE��'��� <br /> ZQD� GQP.-TO '���� <br /> LEGA LOT NO. BLOCK TAACT <br /> DESC. <br /> OWNER AUDRESS LP PHONE q2s 32q o2oa1 <br /> C�S F-wr.un.�s�, SeiW.e�.3 4�2D 20� ST SV�r L��Nv�aooc �14o4b <br /> TENANTNAME ,� CONTACTNAME ?HONE <br /> JEQ.Q.-t�-llrc, 42S �j29 o1p�q <br /> CONTRACTOR gl_ ADDPESS LP CONTR.LICENSE M <br /> PHONE <br /> %UJ ` 'F` I��W�^� `�- ��o��r.,L <br /> PROPOSED USE OF BUILDING I"� Building fl Mechanical I� Addition HEAT SOURCE <br /> PERMIT �__� Combinelion H Plumbing WORK �_� Alteralion � Electric <br /> TYpE u Demolition LJ Sign TYPE �,_t New '�� Gas <br /> �LripGs' �Ml� U Sprinkler U Repair/Maint. Olher <br /> CONTRACT PRICE OF WORK �q 2 a 2� CITY OF EVERETT LOCAL SALES TAX CODE IS J105 <br /> WORKDESCRIPTION VLN.1 QIRNoo QOOF <br /> �J l U�b ,�01 J l� <br /> I �Al\V��W p.CF\►LL�ACTIC <br /> IPLUMBING MECHANICAL <br /> INO. � TVPE OF fl%TURE OR ITEM `-".- � TYPE OF FlXTURE OR ITEM <br /> � WATERCI.OSET � _ _ A/C—A/HANDLINGUNITS <br /> EATHTUB _ FORCED AIR SYSTEMS <br /> �AVATORY (WASH BASIN) _ HEAT PUMP <br /> SHOWER _ UNIT HEATERS I <br /> KITCHEN SINK 8 DISPOSAL _ CIOTHES DRYER <br /> D�SHWASHER _ RANGE HOOD <br /> I ' LAUNDRY TRAY � WATER HEA'tER , <br /> CLOTHES WASHER METAL FIREPLACEJSTOVE <br /> URINAL _ FIREPLACE INSERT I <br /> DRINKING FOUNTA�N _ GAS FIREPLACE <br /> FLOOR DRAIN ,_ GAS RANGE <br /> BACKFIOW PREVENTER _ GAS PIPING j <br /> SINK(SERVICE�BARlMOP/ETC.) EXHAUST FAN <br /> � OTHER_.. _ OTHER <br /> i <br /> -- i <br /> I HEREBY CERITIFY?HAT I HAVE READ AND EXAMINED THIS APPLICATION AtvD KNOW THE SAME i0 BE TRUE AND CORRECT. ALL <br /> PROVISIONS OF WWS AND ORIDINACES GOVERNING THIS TYf'E OF WORK WILL BE COMPlIEO WITH WHFTHER SPECIFIED HEREIN OP <br /> NOT. THE GFANTING OF A PERMIT DOES NOT PneSUME'']GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br /> STATE OR LOCAI LAW REGULATING CONSTRUCTION pR THE PERFORMANCE OF CONS i RUCTION. THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM�i HE WORK FOR WHICH APPUCATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS�W 18.27 FiCW 6��.��pp6.^`00 WAC. <br /> �'"'�1k� ` 1l 1oIIblD2 <br /> SignaWre of OwneUCo t ctor ho d Agent Date la <br />