Laserfiche WebLink
PE►, -MIT APPL.ICATIOI . <br />0�r CITY OF EVERETT PERMIT SERVICES nn <br />3200 CEDAR STREET, EVERETT, WA 98201 �0, 0q-OE -,9/9 <br />< 425-257-8810 - FAX 425-257-8857 <br />SITE ADDRESS PARCEL TAX I.D. # PEPMIT a <br />- -(rt3-r-, A 39 76 7 - 0 2 <br />LEGA L07 NO. BLOC' TRACT <br />DESC. Z9 $ �JC I -7 KAWT C7F Wa't,T VOC.. �j {'L ? 2- <br />OWNER ADDRESS ZIP PHONE <br />f'°L �VFN15a LoIZ-SNZ. ?,*Z } 49rtotLE-- P-IJ q 6 20 3 <br />TENANT NAME I CONTACT NAME PHONE <br />Fig tr�p�} 1W; 20Co. GG�DZ 8�{ i <br />Jh�2-1? I-4M3 bve SL�w^tr-, k✓t-- 9 81 2Z <br />CONTRACTOR ADDRESS ZIP CONTR. LIC =NSE N <br />VLOK6 VIP <br />PHONE <br />PROPOSED USE OF BUILDING <br />Building Mechanical <br />Addition I HEATTCSCURCE <br />PERMIT <br />L^l <br />Combination I ) Plumbing <br />1"ORK <br />Alteration ry Electric <br />ILF�J( <br />TYPE <br />Demolition U Sign <br />T!PE <br />New Gas <br />Sprinkler <br />Repair/Maim. I Other <br />CONTRACT PRICE OF WORK'J)'7, O'CO�j <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />WORK DESCRIPTION ..-�+i�Ni--�'fLtj(�•� Q�(jF.-ii�'-f'PP��►yI E'i$-( BLJU..V �h i�^i�p'e-}�E�i '�I,'7 <br />�- =, -- <br />�G <br />V <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />NO. <br />I TYPE OF FIXTURE OR ITEM <br />„ /C - A/HANDLING UNITS <br />14 <br />BATHTUBERCLOSET <br />FORCED AIR SYSTEMS <br />LAVATORY (WASH BASIN) <br />HEAT PUMP <br />�- <br />SHOWER <br />UNIT HEATI"RS <br />-1_ <br />KITCHEN SINK 8 DISPOSAL <br />�_ <br />CLOTHES OnYER <br />-7 <br />DISHWASHER <br />-7 <br />RANGE HOOD <br />_ <br />LAUNDRY TRAY <br />7 <br />WATER HEATER <br />Z <br />CLOTHES WASHER <br />METAL FIREPLAC&STOVE <br />^ <br />URINAL <br />FIREPLACE INSERT <br />DRINKING FOUNTAIN <br />GAS FIREPLACE <br />1 <br />FLOOR DRAIN <br />GAS RANGE <br />BACKFLOW PREVENTER <br />GAS PIPING <br />SINK (SERVICE/BAR/MOP!ETC.) <br />2-1 <br />EXHAUST FAN <br />OTHER <br />OTHER — <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED <br />THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORIDINACES GOVERNING <br />THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY 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 />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS ,AADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 RRCW AND 296.200 WAC. <br />C'0 <br />3,ctii, oz <br />Signature of Owner/Contractor/Authorized Agent <br />_ Dale L <br />crteL�eKe�- 1�Y Pf�frcEr-'� <br />