Laserfiche WebLink
P'��MIT APPLICATI(. �V <br /> � CITY OF EVERETT PERMIT SERVICES <br /> I <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810— FAX 425-257-8857 <br /> CO ZGIa -(XJ� <br /> SITE ADDRESS PARCEL TAX I.D,k ERMIT <br /> y v / ,��su�• ��C 006oSsv/ '->ov 602 � �bL� -fj0� <br /> LEGA l0T NO. BLOCK TIq/�,CT / � <br /> DESC. 6 �'7� �// L � C / /� � <br /> OWNER ADORESS ZIP PFiONE <br /> KeU,n Swa �05� �yy� I g Tl�o.,.nSo,� /a�c 98.i.o3 yzs=15"5-2CY'!6 <br /> TENANT NAME CONTACT NAME PHONE <br /> SC1MC G.5 a �ovt Sc.� 0.5 A �a�� <br /> CONTRACTOfl ADDRESS 21P CONTR.LICENSE M <br /> Oc.� ne�2 <br /> PHONE <br /> PROPOSED USE OF BUILOING Building n MechaniC31 Adtlition HEAT SOURCE <br /> -/ PERMIT �ombinalion K Plumbing IWORK gAlteration I� Electric <br /> ��;/ � ��0 N TYPE Demolilion Ll Sign TYPE D Ne�v I K Gas <br /> Sprinkler U Fepair/hlaint. LJ Other <br /> CONTRACT PRICE OF WORK CITY OF EVERETT LOCAL SALES CA%CODE IS 3105 <br /> WORKDESCFIPTION n��'.�, a� j /� �� o � eX �S .�1 (� �U/�•C, <br /> �-J fv f� " <br /> ,i� �r ,�. <br /> ./ <br /> I PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTUPE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> I WATER CLOSET A!C-A/HANDLING UNITS <br /> � BATHTUB � FORCED AIR SYSTEMS <br /> �_ LAVATORY(WASH B4SIN) HEAT PUMP <br /> SHOWER UNIT HEATERS <br /> KITCHEN SINK&DISPOSAL CL.OTHES DRYER <br /> DISHWASHER RANGE HOOD <br /> LAUNDRY TRAY WATER HEATER <br /> CLOTHES WASHER METAL FIREPLACE/STOVE <br /> URINAL FIREPLACE INSERT <br /> ORINKING FOUNTAIN _ GAS FIF =PLAG= <br /> FLOOR DRAIN GP.S F!; !GE <br /> _ BACKFLOW PREVENTER GAS PIPING <br /> SINK(SERVICE/BAR/MOP/ETC.) = EXHAUST FAN <br /> OTHER _ OTHER <br /> tti <br /> � <br /> I I HEREBY CE�ITIFY THAT I HAVE READ AND E!(AAIINED THIS APPUCATION AND K�OYV THE SAA7E TO 9E TFUE AND CORRECT. ALL <br /> � PROVISIONS CF LAWS AND ORIDINACES GOVERNING THIS IYPE OF WORK WILL BF COIdPU[D WITH WHEfHER SPECIFIED HEREIN OR <br /> I NOT. THE GRA�VTING OF A PERh11T DOES NOT PRESUM1IE TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br /> STATc OR LOCAI LAW REGULATING CONSTRUCTION OR THE PERFORM1IANCE OF CONSTFUCTION. THAT I AM AUTHORI2E�BY THE <br /> j OWNER OF THIS°FOPERTY TO PERFORM I HE WORK FON WHICH APPLICATION iS MADc AND I COMPLY WITH THE STATE <br /> � CONTPACTO LAIV 18. D 296.200 WAC. <br /> � .. �., ��L ��° �oz <br /> Sign lure of Owner/ onlractor/Aulhorized Agent Date �/� <br /> � � <br />