Laserfiche WebLink
SITE ADDRESS <br />LOT NO. <br />Ta���>�.F a� <br />� I�C, CVa, e.! i- l�It�; (, <br />TENANT NAME <br />11�e- /-v�..•� 4 <br />CONTRACTOR <br />�en rY�rc.i.�n <br />PHONE <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 <br />PAFCEL TAX I.D. X <br />��.��-� ���� d9os i400 3� � <br />BLOCK TRAC7 <br />�Mj¢i OS SP(�F:tn I� ���,.4.r �l,J <br />!Mar'.'��- V•Oay-� ADDRESS <br />pr.c+r� � . <br />;Crn�i nt�tr dGio We+M�c, /��� C-.vx�t+ <br />.�Ro1 HoyT P't CONTACTNAME j�l. M�„r <br />� ,..� <br />t��.��.,,.n ���� (`�.af{a--?4a,t�; <br />+ YIPvII/1y� I./�C <br />3s�� -757- G9o9 <br />PROPOSED USE OF BUILDING <br />C'Z c�.,N�'.1,-C.,_\ <br />hir:cc. <br />CONTRACT PRICE OF WORK I G <br />WORK DESCRIPTION <br />�.��S�t�\ �l� Iv-- 5VS�Y1`1.1 <br />NO. I TYPE OF FI%TURE OR ITEM <br />WATER CLOSET <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SNOWER <br />KITCHEN SINK 8 DISPOSAL <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTER <br />SINK (SERVICEIBAR/MOP/ETC.) <br />OTHER <br />ADDRESS <br />ISiY �u.-F 17r.��- <br />(i�-�,�y1.�, c�A 9b23� <br />Building Meclianical <br />PERMIT R Combination � Plumbing <br />nve j� Oemolilian Sign <br />U Sprinkler <br />PERMIT # <br />`�f?G6 Nas{33913 � <br />PHONE 3�_�S'�- <br />��5 <br />21P CONTR. LICENSE � <br />t�e��"-�-ZOGG6 <br />Addition HEAT SOURCE <br />WORK Al�eration E�ecidc <br />nre New ces <br />Repair/Maint. Other <br />CITY OF EVERETT LOCAL SALES TA% COOE IS 1705 <br />'�A �'z cTi-�,tw �p�CC�... <br />NO. I TYPE OF FI%TURE OR ITEM <br />AfC - AIHANDLING UNITS <br />FORCED AIR SYSTEMS <br />L HEAT PUMP <br />UNIT HEATERS <br />CLOTHES DRYER <br />RANGEHOOD <br />WATER HEATER <br />METAL FIREPLACEISTOVE <br />FIREPLACE INSERT <br />GAS FIR[PLACE <br />GAS R�NGE <br />GAS PIPING <br />� EXHAUSTFAN <br />I HEREBY CERITIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AN� KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TVPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN 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 LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORM1IANCE OF CONSTRUCTION. THAT 1 AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR W HICH APPLICATION IS MA�E AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW�1827 RCW AND 296200 WAC. <br />_ � I l �ov/oz <br />q <br />