Laserfiche WebLink
�`ERMIT APPLICA��N <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810- FAX 425-257-8857 � Z �z - �� <br /> Or,v a ia - a�7 <br /> SITE ADDRESS PARCEL TAX I.D.N P,€qMIT M <br /> . � lJ�`� - <br /> LEGA LOTNO. BLOCK TRACT � <br /> OESC. <br /> OWNER AD�RESS LP PHONE <br /> <}r_,�ir�7`�_ �.(„-Pe,- 3�1� �i�L,l�a � 4�5 9-�9z� <br /> TENANTNAME CONTACTNAME PHONE <br /> CONTRACTOIi, �(�.� �U ADORESS $�2_3�3��l• N-IV. LP CONTR.LICENSE N <br /> S7ZLnu.FCB1, Wi¢ �`�1� <br /> PHONE <br /> `�;ZS � 3`l5 �1733 �{f�T'IS/�•�1t py1KS <br /> PROPOSED USE OF BUILDING �Y BUilding fl MeCheniCal Addi!ion HEAT SOUR�E <br /> PERMIT KL�1 Cambination �_� Plumbing WORK aitera�ion Q Eteccr�c <br /> TYPE U Demolition �� Sign 7YPE � New �,] Gas <br /> R� U Sprinkler RepairRdaint. I U Othar <br /> CONTRACT PRICE OF WORK/7�3�p� CITY OF EVERETT LOCAL SALES TA%CODE IS 3105 <br /> Ijr , <br /> WORK DESCRIPTION <br /> � (�+:�-huot M�� /v 'O"x��'o" 5��1c Ca.- Ca�*.cryc� <br /> �� I /� i✓� �1 ._�� �� . A i�'� <br /> \J' ' <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FlXTURE OR REM NO. TVPE OF FI%TURE OR ITEM <br /> WATER CLOSET A!C—A/HANDLING UNITS <br /> BATHTUB FORCED AIR SYSTEMS <br /> j _ LAVATORY(WASH BASIN) HEAT PUMP <br /> � _ SHOWEFi UNIT HEATERS <br /> � _ KITCHEN SINK 8 DISPOSAL _ CLOTHES DRYER <br /> DISHWASHER RANGE HOOD <br /> LAUNDFY TRAY WAT[R HEATER <br /> CLOTHES WASHER METAL FIREPI.ACE/STOVE <br /> URINAL FIREPLACE INSERT <br /> DRINKING FOUNTAIN . _ GAS FIREPLACE <br /> FLOOR GRAIN GAS FANGE <br /> I _ BACKFLOW PREVENTER _ GAS PIPING <br /> I SINK(SEFVICE/BAr7/MOP/ETC.� EXHAUST FAN <br /> OTHER OTHER <br /> I HEREBY CERITIFY?HAT I HAVE READ AND EXAI.IINED THIS APPLICATION AND KNOW THE SAME TO BE-TAUE AND CORRECT. ALL <br /> PROVISIONS OF W WS AND OqIDINACES GOVEFNING THIS TYPE OF WORK WILL BE COAIPLIED WITH LVHETHER SPECIFIED HEREIN OR I <br /> NOT. THE GRANTING OF A PERI.IIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY CiHER <br /> STATE OR LOCAL LAW REGULITING CONS i RUCTION OR THE PERFORh1ANCE OF C04STRUCTION. THAT I AM AUTHORIZED BV THE <br /> OWNEF OF THIS PROPERTY TO PERFORhi THE WOIiK POR�YHICH APPLICATION IS A1ADE AND 1 COMPLY WITH THE STATE <br /> '--.� CONTRACTORS LAW 1827 RCW AND 296.2001VAC <br /> n l <br /> ,s�l�a,�� �i •<'t��,..,_ i�/�/� <br /> Sign u2�ol dwn uContractor/Authonzed Agenl � Date �� <br />