Laserfiche WebLink
\' <br /> pcRMIT APPLI�ATILN <br /> � CITY OF EVERETT PERMIT SERVICES <br /> i 3200 CEDAR STREET, EVERE7T, WA 98201 <br /> � 425-257-8810- FAX 425-257-8857 <br /> � - PJI� ?,D""J -UI <br /> i S�1 E AUDRESS PARCEL TN( I.D.t I PERMii a <br /> �° � - � Cd3 �7 -ai3 <br /> ILEGA LOTNO. BLOCN TRAf.T �� ����_' �� ' JL� <br /> , DESC � _ _ _ _ <br /> OWNER AD RESS ZIP PHONE <br /> , �2k��e�c�'itt�l�F+�=s,'�,�� _ 3129 G�=n-rc�,= �ir �u ynr- �b'7Dl HZs= ��9 - 9C/,�_ <br /> � TENANT NAME I CONTACT FOR PERMIT PHONE <br /> I l )T]Vi- Cld!'T ��(il. ���5' ��7 ' �C���1— <br /> i CONTRACTOR S�M� �� ��� ApORESS ZIP CONTR.LICENSE N� <br /> PHONE ' C'/��U � T � S <br /> i PROPOSED USE OF BVILDING I IQ� Bwlding f'1 �Aachanical AAdNon HEAT SOURCE <br /> � PERMIT fit Combinatbn �_� Plumbiny WORK NleraUon Elecinc <br /> � TYPE �l DPmolilion U Sign TVPE � N p �Ga� <br /> IJ u S nnkler Re aiublaint. OUier <br /> CONTRACT PRICE OF WORK CITY OF EVERETT LOCAL SALES TAX CODE IS J10S <br /> � WORKDESCRIPTION <br /> I <br /> I r <br /> PLUMBING MECI�ANICAL <br /> NO. TYPE OF FU(TURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> �' WATER CLOSET(TOILET) A/C-NMiANDLING UNITS <br /> �ATHTUB _L FORCED AIR SYSTEMS <br /> „� LAVATORY(WASH BASItJ) HEAT PUMP <br /> SHOWER UNIT f1EATERS <br /> �_ KITCHEN S�NK d DISPOSAL _j_ CLOTHES DRYER <br /> � .L DISHWASHER _� RANGE HOOD <br /> IAUNORY TRAY _L WATER HE/1TER <br /> � CLOTHES WASHER METAL FIREPLACE/STOVE <br /> URINAI FIREPLACE INSERT <br /> i = DRiNKING FOUNTAIN _ Gl�S FIREPLACE <br /> FLOOR DRAItJ GAS kANGE <br /> _ BACY.FLOV✓PREVENTER � GAS PIPING <br /> _ SINK(SERVICE�BAWMOP/ETC.) � EXHAUST FAN <br /> _ OTHER _ OTFiER I <br /> I — _ <br /> I — f — <br /> �I i NEREPY CERITIFY THAT i HAVE REAO AND E%ti1.11NED TNIS APPLICATION AND KIlOW TIiE SAME TO BE TRUE AND CORRECT. AlL <br /> � PAOV�S10�15 OF lAWS HHD ORIDiNACES GOVERNING TMIS TYPE OF WORK R'ILL DE COMPLIED WIiH WHETHER SPEGFIED MEREIN OR <br /> Npi TME GRANTRIG CF 4 PERtAIT COES NOT PR[SUfdE TO GIVE AUTHORITv TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br /> � SiATE OR IOC�L LAY!REf;ULATRJG CONSTRUCTION OR THE PERFOR1dANCE OF CONSTRUCTION. THAT I Ah1 AUTHOIt12ED OY THE <br /> � p•;;tlE�7 Of 7H15 f qGPE�TY TO PERFORM THE VJORK FOR WNICH APPLICATION IS MADE AND I COMPLV WITH THE STATE <br /> i �ptJTRACTOR Y B27 RC7!AND 295 Y00 WAC. <br /> i � t�� 7 -� � � \ <br /> S�turoo nerl n actcr/Auth odA9en1 Dato �I_ 1 <br /> DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED `"VI L <br /> / <br />