Laserfiche WebLink
PERMIT APPLICATION <br />CITY OF EVERE7T PERMIT SERVICES <br />320� CEUAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 <br />31a� <br />SITE ADDRESS . <br />vQ �va <br />��� n �a TRACT <br />V <br />F� r5 Q o, � <br />TENAHT AME <br />�I�T QO.��'1y1 <br />CONTRACTOR <br />KEv►n vi� g <br />PHONE �( O- V✓�--O- J u <br />�� J O <br />PHOPOSEO USE OF BUIIDING <br />�� � • <br />CONTRACT PRICE OF WORK <br />rax i.o. e <br />��� �_; Ob <br />�1f� I� Ib <br />CONTI�CT NAME <br />on�a� e� <br />i�ie ��a °I <br />a(�Or�►�n6 u <br />PER111T N <br />//- � <br />PHONE <br />�1 �-1S� 25°��0116,6 <br />PHONE <br />`�'�•�?��"1 °I�b� <br />(�(CO,V��I��S � LP CO CE SE1 <br />K�.J� �'a`� 5� RC <br />j�.U10 � l��+. 5+-N� l.AleE s����s 5'��58 <br />Building Mechenicel <br />PERMIT �Combinatlon R Plumbing <br />TYPE DemOliilOn ❑ Sign <br />Sprinkler <br />Addilion MEAT SOURCE <br />WORK R Alterelbn j� Elaclric <br />TYPE D New ❑ pee <br />U Rapair/Melnl. � Other <br />CITV OF EVERETT LOCAL SALES TAI( COUE IS 7105 <br />WOHK OESCNIP O , � <br />�.A.,m u i n o� b� t n %,.i �'4� W�R�Y,Q QVe <br />�C"-_ .�la� �� �� <br />NO. � TYPE OF FI%TURE OR ITEM <br />WATER CLOSET <br />BATHTUB <br />_ LAVATORY (WASH DASIN) <br />__ SHOWER <br />KITCHEN SINK 8 DISPOSAL <br />DISHWASHER <br />LAUNDRY TF�Y <br />CLOTHES WASHER <br />URINAI <br />DRINKING FOUNTAIN <br />FLOOR ORAIN <br />BACKFLOW PREVENTER <br />_ SINK (SERVICElBAR/MOPlETC.) <br />OTHER <br />NO. � TYpE OF FlXTURE OR ITEM <br />� <br />ivu - ahiqNDLINp UNITS <br />FORCED AIR SYST[MS <br />HEAT PUMP <br />UNIT HEATERS <br />CLOTHES DRYER <br />RANOE HOOD <br />WATER HEATER <br />METAL FIREPLACE/STOVE <br />FIREPLACE INSERT <br />GAS FIHEPLACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUST �AN <br />OTHER <br />I HERECiY CERITIFY THAT I NAVE READ AND EXA671NED THIS APPUCATION AND KNOW THE SAME TO BE THUE AND CORRECT. ALL <br />PROVISIONS OF IAWS A vD ORIUINACES GOVEf�NING THIS NPE OF WORK W�LL 9E COMPLIED WITN WHETHER SPECIFIED HEREIN OR <br />N07. THB GRANTING OI� A PEf'MIT DOES NOT PHESUME TO GIVE AUTHORIN TO VIOLATE OR CANCEL THE PROVISION OF ANY OTNER <br />ST�TE OR LOCN_ LAW R�(9ULi\TING CONSTHUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTNORIZED BV THE <br />OWNER OF THIS PROPERI': TO PERFORM THE WORK FOR WHICH APPUCATION IS MADE ANO I COMPLY WITH THE STATE <br />CONTHACTOfiS I.AW iB27 RCW AND 296.200 WAC. <br />� <br />