Laserfiche WebLink
PERMIT APPLICATIGN <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 <br />SITE AD RESS <br />PARCEL TAX I.D. H <br />PERMIT <br />�,5/ti �l :�i rr✓r/ri�lU %ff-"'� <br />�7to 30003oo5'oC� <br />`N <br />I�L�O <br />LEGAL <br />LCITNb. <br />BLOCK <br />TRACT <br />DESC. <br />I <br />OWNER/ r ADDRESS <br />7� GO CPc�G! /✓re� <br />c%42o <br />!PHONE <br />14.25 'ri5-�rsJJ <br />/ I E✓yir f/ 6G✓% / <br />TENANT NAME CONTACT NAME <br />� <br />Rt h-l' e aWi f - L1rt 11f/',e 5 /�>Cr�/l d %�f' <br />PHONE <br />12� = �5 / - r /' 7 <br />ONTj1ACTOR <br />tri c �'r Sl` C rrs/uc/rc�t <br />ADDRESS S <br />/3G/`J M4%.liro �rlcr'wv <br />% <br />CONTR. LICENSE 0 <br />PHONE.. _ <br />� ,,.rw„•� w9/ ��U�� <br />(',�C'_)F<<�uiBB <br />f,. - av'3 .- 7Y23 <br />PROPOSED USE OF BUILDING <br />PERMIT <br />TYPE <br />uilding Mechanical <br />FCarnbinalionPlumbing <br />emolition D Sign <br />WORK <br />TYPE <br />Addition <br />Alteration <br />New <br />HEAT SOURCE <br />(-Electric <br />B Gas <br />(9prinkler <br />Repair/Maint. <br />Other <br />CONTRACT PRICE OF WORK lV OK T <br />CITY OF EVEREFF LOCAL SALES TAX CODE IS 3105 <br />WORK DESCRIPTION �J7 5'/r[tc/ vlru/ %/:/rr Du5° L� EMC�c-G' 5 TLt c /w�� c <br />r <br />r� 47&(e LL':'�(•(y Pifi S/i/�" 7iC..t'✓< hc,?g¢ %(l cm 4ecf �//I d yr/ir G.q <br />90 /LllLrtw�SL� <br />%LL'C' 5,/u(fuu / O Ci5h' � f/Y�Gfo <br />l& o S F v- /l rcd 5 u rfu �e / <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />NO. TYPE OF FIXTURE OR ITEM <br />WATER CLOSET <br />A/C - A/HANDLING UNITS <br />_ <br />THTUB <br />FORCED AIR SYSTEMS <br />_ <br />lA TORY (WASH BASIN) <br />HEAT PUMP <br />_ <br />SHO <br />UNIT HEATERS <br />KITCHEN K & DISPOSAL <br />CLOTHES DRYER <br />_ <br />_ <br />DISHWASHE <br />RANGE HOOD <br />_ <br />LAUNDRY TRAY <br />TER HEATER <br />_ <br />CLOTHES WASHE <br />ME FIREPLACE/STOVE <br />_ <br />URINAL <br />FIREPLACE INSERT <br />_ <br />DRINKING FOUNTAIN <br />GAS FIRE CE <br />_ <br />FLOOR DRAIN <br />GAS RANGE <br />_ <br />BACKFLOW PREVENTER <br />GAS PIPING <br />_ <br />SINK (SERVICE/BAR/MOP/ETC.) <br />EXHAUST FAN <br />OTHER <br />OTHER - <br />I HEREBY CERITIFr THAI I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORIUINACES GOVERNING 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 MADE AND I COMPLY WITH THE STATE <br />CONTRA ORS LAW t&2TRCW AND 296.200 WAC. <br />k�L <br />Signature o; Jwner/ ontraclor/Authorized Agent Date /a !, <br />