Laserfiche WebLink
� <br />� <br />S�TE ADDRESS <br />� �:i�o $un,Mi�- <br />LEGA LOTNO. <br />P�r�MIT APPLICATI(�J <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 <br />�L <br />I BLOCK <br />PARCEL TAX I.D. 7i <br />oolooag- yba-o2o-00 <br />TRACT <br />MIT M <br />a / O Oc�� <br />Do��s r►��.� a.s�e So�M�� Avc �ae.�- u��l, q�ao� a5's-�9c3 <br />TENANT NAME CONTACT NAME PHONE <br />Qrrie Nlrw�on hl�kt Larsw• y�S-3�7--i535 <br />CONTRACTOR <br />L[t.rst�+ <br />PHONE <br />wc_ <br />Co..s�'. <br />asss <br />PROPOSED USE OF BUILDING <br />%Zls�a�o/ <br />CONTRACT PRICE OF WOPK�Q'G <br />p .J <br />WORK �ESCRIPTION �i'r��� <br />r <br />fi�.� <br />PLUMBINI <br />NO. I TYPE OF FI%TURE OR ITEM <br />ADORESS �1� � w� ZIP CONTR. UCENSE M <br />3�0 Al��rson dlw� ?P�� �S�G+�rlol0e► <br />Building <br />PERMIT Combinatlon <br />TYPE Demolition <br />Sprinkler <br />S�o�s � �Y'�t'r <br />N..� •lleur��y <br />WATER CLOSET <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK & DISPOSAL <br />DISHWASHER <br />LAUNDRY TRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTER <br />SINK (SERVICE/BAR/MOP/ETC.) <br />OTHER <br />Mechanical <br />Plumbing <br />Sign <br />n Adtlition <br />I"S Aperetion <br />k�( New <br />16f Repair/Maint. <br />HEATSOURCE <br />D Electric <br />[� Gas <br />U other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />qa�y� �� s suf�:►�� ntv �too�� <br />NO. I 7VPE OF Fl7(TURE OR REM <br />A/C —A/HANDLING UNITS <br />FORCED AIR SYSTEMS <br />iiEAT PUMP <br />UNIT HEATERS <br />CLOTHES DRYER <br />RANGEHOOD <br />WATER HEATER <br />METAL FIREPLACE/STOVE <br />FIREPIACE INSERT <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUST FAN <br />I HEREBY CERITIFY THAT I HAVE PEAD AND EXAMINED THIS APPIICATION AND KNOW TNE SAME TO BE TRUE AND CORRECT. AlL <br />PROVISIONS OF W WS AND ORIDINACES GOVERNING THiS NPE OF WORK WILL BE CQMPLIED WITH WHEfF1ER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT OOES NOT PRESUME TO GIVE AUTHOFITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br />STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNEF OF THIS PROPERN TO PERFORM THE WOFiK FOF WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTOFS LAW 18.27 RCW AND 296.200 WAC. <br />.�7-OZ <br />