Laserfiche WebLink
P�":MIT APPLICATIO� <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 TAJ(I,D.A PERMI7 x <br /> 3�l c.`7iyiiTr� � ���— <br /> LEGA LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER A�ORE55 nr PMONE <br /> [�?l1>ST ///�7�5 �G�C�Y 7709 �// N7i 1���—�,� <br /> TENANTNAAIE I CONTACTNAME PHONE <br /> LZ�L�T_ <br /> CONTRACTOR ADDRESS ZIP CONTR.LICENSE N <br /> cCie�T�6/LEZ—�cS7`�97� H�9i� �C. 2/ZO ��t- �62vI `/y� <br /> PHONE Eti�"x�'�S�Z2�— <br /> PROPOSED USE OF BUILDING BUflding �p,��BCheniCal � /�dilion HEAT SOURCE <br /> PERMI7 R�-( Combination ��-.j( P_lumbin WORK ��-1Q�/Alteralion Q Electric <br /> I TYPE �J Demolilion LJ Sign 9 TYPE �j New �,,,) Gas <br /> ILJ Sprinkler L� Repair/MainL U Other <br /> CONTRACT PRICE OF WORK �'C'�S� d'_.�-' CITY OF EVERETT LOCAL SALES TA%CODE IS 3105 <br /> 1 <br /> WORKDESCRII=TION ����5� f T�S,,,�� �� CkJth'li-ST Fath-� � I�-CTTU k��J �(kfMl� <br /> 1 � <br /> � L o kvL.� "Tf+hT �'ic.�5 '�t(o�,..�-�(LDo.K- <br /> I <br /> j PLUMBING MECHANICAL <br /> � NO. TYPE OF FIXTURE OR ITEM N0. TYPE OF FlXTURE OR REM <br /> WATER CLOSET _ A/C-A/HANDLING UNITS <br /> � _ BATHTUB _ FORCED AIR SYSTEMS <br /> LAVATOFY(WASH BASIN) _ HEAT PUMP <br /> I = SHOWER _ UNITHEATERS <br /> KITCHEN SINK 8 DISPOSAL _ CLOTHES DRYER <br /> � DISHWASHER RANGE HOOD <br /> LAUNDRY TRAY WATER HEATER <br /> � _ CLOTHES WASHER _ METAL FIREPLACE/STOVE <br /> URINAL _ FIREPLACE INSERT <br /> DRINKING FOUNT;,IN . _ GAS FIREPLACE <br /> FLOOR DFAIN GAS RANGE <br /> BACKFLOW PREVENTER GAS PIPING <br /> SINK (SERVICEBAR/MOP/ETC.) EXHAUST FAN <br /> OTHER _ OTHER <br /> I HEREBV CEflITIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND COFRECT. ALL <br /> PROVISIONS OF 1:1W5 AND ORIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OF <br /> NOT. THE GFANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORIN TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br /> STATE OR LOCAL LAW REGULATING CONSTiiUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT�AM AUTHORIZED BY THE <br /> OVVNER OF THIS PROPEAIY TO PERFOFM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTFACTORS L1W 18..7 RCW AND 296200 WAC. <br /> Signature ol OwnedContractor/Authorized Agent Date <br />