Laserfiche WebLink
� <br /> l��RMIT APPLICAT�IN <br /> riTY t�F EVEREl'��' PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810— FAX 425-257-8857 � <br /> - Q i,� D z v � -ai� <br /> SITE ADDRE5S PARCEL TAX I.D./ pEpMR� <br /> 96ZJ 2s� :D/,� SE EX�9yo7- o�_o5io—oD cd3o � -ocv <br /> LE(iA LOT y0. BLOCK T � � � <br /> DESC. 5�0 <br /> OWNER DDyESS ZIP PHONE <br /> %f3/6 .sr� GKSf�.��5 �� <br /> le�-e:%f�a+r�1 rlir/ �n/� L�¢/errrNl 9�zs8 3�</-0��73 <br /> TENA NAME COMA NAME <br /> / PHONE <br /> �' " -'t J�C�Z�-�!L_ �'�j�l'"C%'Sr���� �i <br /> CONTR A�l� (� , ADDRESS tZ '3�-. ZIP ' •COMR.UCENSfi��'-- <br /> PHONE <br /> ' ' ,' '�Ct6.�tE'�.✓o�/�/�K <br /> PROPOSEDUSEOFBUILDING Building Mechanical � Addilion HEATSOURCE <br /> S�� PERMIT �Combination RL.�/ Plumbing WORK niieration ln..[ Electrk <br /> TYPe Demolition �J Sign TYpe �New }¢Gas <br /> Sprinkler Repair/Maint. U Other <br /> CONTRACT PRICE OF WORK CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> WORK DESCRI��T10N <br /> I ' <br /> �l%r�'i � ��// I <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYpE OF FIXTURE OR ITEM <br /> WATER CLOSET A/C—/VHANDLING UNITS <br /> � BATHTUB T FORCED AIR SYSTEMS <br /> � LAVATORY(WASH BASIN) '^ HEAT PUMP <br /> -^ SHOWER — <br /> � KITCHEN SINK R DISPOSAL — UNIT HEATERS <br /> � DISHWASHER � CLOTHES DRYER <br /> -� LAUNDRY TRAY _L RANGE H000 <br /> .� CLOTHES WASHER . -� WATER HEATER <br /> URINAL = METAL FIREPLACE/STOVE <br /> DRINKING FOUNTAIN — FIREPLACE INSERT <br /> FLOOR DRAIN ' GAS FIREPLACE <br /> � _ BACKFLOW PREVENTER GAS RANGE <br /> ._ SINK(SERVICE/BAR/MOP/ETC. — �AS PIPING <br /> OTHER � EXHAUSTFAN <br /> - - _ OTHER <br /> i — <br /> 1 HEREBY CERITIFY THAT I HAVE READ AND EXAMINED THIS APPLICAiION ktJD KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br /> PROVISIONS OF IAWS AN�ORI�INACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PEFMIT DOES NOT PqESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER � <br /> STATE OR LOFAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br /> OWNER�IS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MA�E AND I COMPLY WITH THE STATE <br /> CONT RS 18 7 W AND 298200 WqC, <br /> '�� �-- ���' � <br /> Signatu ol wner/ ontractodAuthorize Agent ete � <br /> Z <br />