Laserfiche WebLink
SITE ADDRESS <br />'�-V L �U <br />LEGA LOT NO. <br />oesc. 15 � 2;:� <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 />BLOCK <br />I� <br />PARCEL TAX I.D. k <br />(;fSflTol. <br />QC�: � =P '!� <br />�UL YI� <br />� <br />44KEL,hs�IO l�ar�� S�n� � o, r3ox 3�� ��� %� yFzo 3 <br />TENANT NAME CONTACT NAME PHONE <br />S'rti�7V� t�.�v�.�dllS '-lZ$'3SL'77G7 <br />CONTRACTOR ADORESS ZIP CONTR, LICENSE N <br />]:[U2I� <br />PROPOSED USE OF BUILDING <br />1�7yo � S�2 <br />Building Mechanica' <br />PERMIT �mbination R Plumbing <br />TYPE Demolilion d Sign <br />Sprinklef (M ol heads) <br />Addition MEAT SOURCE <br />WORK R Alteration Electric <br />7YPE ��J'TSew s <br />�� RepaidMaint. Olher <br />CONTRACT PRICE OF WORK —yQ ' O� CITY OF EVERETT LOCAL SALES TA% CODE IS 3105 <br />1 <br />WORK DESCqIPTION <br />/Ue� I�a��sc. %�lue �i�.��e l���c, 2��oQ <br />NO. I TYPE OF FI%TURE OR ITEM <br />�1 <br />WATER CLOSET (TOILET) <br />BATHTUB <br />LAVATORV (WASH BASIN) <br />SHOWER <br />KITCH[N SINK & DISPOSAL <br />DISHWASHER <br />LAUNDRY TRA'f <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTER <br />SINK (SERVICE/BAR/MOPlETC.) <br />OTHER <br />NO. I n'PE OF flXTURE OR fTEM <br />A/C - A/HANDLI NG .UNITS <br />,�_ FORCED AIR SYSTEMS <br />_ HEAT PUidP <br />UNIT HEATERS <br />� CLOTHES DRYER <br />� RANGE HOOD <br />�WATER HEATER <br />METAL FIREPLACE/STOVE <br />FIREPLACEINSERT <br />�- GAS FIREPLACE <br />�GAS RANGE <br />GAS PIPING <br />� EXHAUST FAN <br />OTHER <br />I HEREBY CERITIFY THAT I IfAVE READ AND EXAMINED THIS APPLICATION hND KNn4V TH� S/�ME TO BE T�RUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TYPE UF WORK V�'ILL OE COMPLIEU W{TH WHZHER SPECIFIED HEREIN OR <br />NO7�. THE GRANTING OF A PERMIT DOES NOT °RESUME TO GIVE AUTHORITY TO VIOLATE OR CAfJCEL THE PROVISION OF ANY OTHER <br />STATE OR LOCAL LAW REGULATING COIJSTflUCTION OR THE PERFORM�NCF OF CONSTRUCTION. THAT I AM AUTHORIZED BV THE <br />OWNER OF THIS PROPERN TO F'ERFOR41 THE WORK FOR WHICH APPLIGATION IS MADE AtJD I COMPLV WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW ANQ 296.200 WAC. , , <br />��— <br />ate l/� <br />