Laserfiche WebLink
SITE ADDRESS <br />2 3Q , <br />LEGA LOT NO. <br />DESC. c f i <br />TENANT NAME <br />P�RMIT APPLICATI(��� <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 <br />/yj��a04q�L. <br />R� v, <br />BLOCK <br />�7� I P[A% aF o?,�co CqA/7dc <br />v9 A�DRESS M��� ���� <br />„� <br />2� � �- � dE. <br />PARCEL TAX I.D. M <br />I aa�fv/6-�f96-Q�S- ab <br />TRACT <br />CONTACTNAME <br />PERMIT A <br />�� I b - oo� <br />,c✓�rJ 1/eL. � ��, ?� <br />PHO E <br />y.�s-z s8 • o �� � <br />PHONE <br />I /!�/c�,yE2 /h�v�y 'fa.�- &�Q -/f�i�a <br />CONTHACTOR `� n�a 7r �`�S�2C:��7QI,�J ADOflESS ZIP CONTR. LICENSE N <br />�7 ��f3� ��2No hl,r,�. � Mq[�Yc - o ��a�{ <br />PHONE 366-652- oa� �7%�/S�/� `u'��� <br />PROPOSED USE OF BUILDING <br />S,F. 2. <br />Building Mechanical <br />PEaM17 � Combination � Plumbing <br />TYPE Demol�tion Sign <br />Sprinkler <br />CONTRACT PRICE OF WORK !Ga /��Z W <br />,S" 7• <br />WORK DESCRIPTION r �STn1I C/ 7� /U�L✓ <br />/U <br />�1=i5!/hK �E'GS�OE�! �N <br />NO. I TYPE OF Fl%TURE OR ITEM <br />WATER CLOSET <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 DISPOSAL <br />DISHWASHER <br />LAUNDRY TRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTEF <br />SINK jSERVICE/BAR/MOP/ETC.) <br />OTHER B/a� <br />TYPE <br />Addition I HEATSOURCE <br />Alleralion Electric <br />New � Gas <br />RepaidMainl. L) Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />.�i!/O S%dai Q�T 'Q46 M, //•J <br />�C/ (//nK .S/�i9 cc�' <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C -A/HANDLING UNITS <br />FORCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT HEATERS <br />CLOTHES DRYER <br />RANGEHOOD <br />WATER HEATER <br />METAL FIREPLACE/STOVE <br />FIREPLACE INSEFT <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUST FAN <br />OTHER <br />I HEREBY CERITIFY THAT 1 HAVE READ AND EXAMINED THIS APPLICATIUN AND KNOW THE SAME TO BE TRUE AND CORFECT. ALL <br />PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMP�IED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOL4TE OR CANCEL THE PRO`/ISION OP ANY OTNER <br />STATE OR LOC.1L LAW REGULATING CONSTRUCTION OR THE PERFORA7ANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERN TO PEPFORM TNE WORK FOR WHICH APFLICATION IS MADE AND I COMPIY WITH THE STATE <br />CONTRACTORS L.AW 1827 RCW AND 296200 WAC. <br />�L <br />