Laserfiche WebLink
�- CRMIT APPLICATiJN <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810- FAX 425-257-8857 <br /> SITE ADDRESS PARCEL TAX I.D.# RMIT# <br /> �j'-I °I �.�tLt� R� - c, 'l�r. � 7L�LiL� S�L��_�(Li_��� ��� <br /> LEGAL LOTNO. B OCK TRACT <br /> DESC. � <br /> OWNER ADDRE55 ZIP PHONE <br /> �� -+- �.n-u�vis �:}!`s� 54q Vicr.J (� tic ��� Fi,�rc� 943:103 ,251. -6�1 <br /> TENANi NA E CONTACT FOR PERMIT PHONE <br /> m,kz ���+ .���- ���� �- ���� <br /> CONTRACTOR I � f ADDRESS 21P CONTR.LICENSE N <br /> i,t7l��ea�- C.cu}-t�-i►�c� ��. ��-c� E7.4�r� h��. <br /> PHONE WNEA'TCr �%��(-1 j <br /> �Izs - 3�Ir� � 33�6 M,:k�l ♦c,�� cu�. 9fi,2�," <br /> PROPOSEO USE OF BUILDING I ,�}�.,(.Building �Mechanical Addition HEAT SOURCE <br /> PERMIT �Combinalion Plumbing WORK � Alteratlon �Electnc <br /> s �' Z TYPE Demoliticn Sign I7YPE New I Gas <br /> Sprinkler Repair/Maint. Other <br /> CONTRACT PRICE OF WORK CIN OF EVERETT LOCAL SALES TAX CO�E IS�105 <br /> WORK DESCRIPTION <br /> i �� lS�l !-IoMP �— '�')�'S,UG AS�t l '+[�IZ, <br /> � I.J� D L �7 C= <br /> PLUMBI G MECHANICAL <br /> I NO. TYPE OF FIXTURE OR ITEM N0. TYPE OF FIXTURE OR ITEM <br /> �� <br /> 5 WATER CLOSET(TOILE� � A1C—A/HANDLING UNITS <br /> � BATHTUB � FORCED AIR SYSTEMS <br /> LAVATORY(WASH BASIN) HEPT PUMP <br /> I � SHOWER UNITHEATERS <br /> I � ITCHEN SINK& DISPOSAL �2 CLOTHES DRYER <br /> � � SHWASHER I NGE HOOD <br /> � LA 'NDRY TRAY 1 WA R HF.ATER <br /> � CLO HES'NASHER META FIREPLACE/STOVE <br /> _ URINA FIREP E INSERT <br /> DRINKI FOUNTAIN .!� GAS FIRE CE <br /> ,� FLOOR D IN T GAS RANG <br /> BACKFLOW EVENTER � GAS PIPING <br /> � SINK (SERVIC BAWMOP/ETC.) �`' OTHERSTF N. 1L <br /> OTHER _ Q��,K;'�' �c�ci" <br /> — F�tM <br /> i - - <br /> ;HEREBY CERITIFY THAT I HAVE REA AND E.YAMINED THIS APPUC4TION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br /> PROVISIOYS OF LAWS AND ORIDINAC GOVERNING THIS TVPE OF WORK WILL BE COMPLIEO WITH 1NHETHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERA1IT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOWTE OR CANCEI.ThE PROVISION OF ANY OTHER <br /> STATE OR LOCAL LA1N REGULiTING CONSTRUC i ION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR 1NHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTOR LAV� 1B.^.7 RCIV AN 29R200 WAC. I <br /> � / � q I:� 03 � <br /> Signature Owner/ContractonAuthonzedAgent Date i� i <br /> DEBIT & CREDIT CARDS ARE NOT ACCEPTED '� <br />