Laserfiche WebLink
r, �v <br /> � —� <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERET7',WA 98201 <br /> 47_5-257-8810-FAX 425-257-6857 <br /> SITE ADDRESS �U 3i�� 1�1�TIi� �s, E� � PARCEL TW(I.D.NOprj�77-�ill-pJ( - PERMiT � . . <br /> l�t.t�G- lk S�. ' r q�2dd C;G5�5-(xt�- ; � ��l � <br /> t C�i i�',�• <br /> LEGAL LOT NO. BLOCK TMCT <br /> DESC. -. <br /> ADDRESS 21P PHONE <br /> OW NER �ZS-3>`�-I y�3 <br /> �� ,�1f 1 ;TA1f�(' �"?�i?i I<<1 �4 �•.l�C `�F�C��1 S�tii.rF lO�i- ,�/�'n�+-r �j4 LU�d <br /> CONTACTFORPERMIT PNONE <br /> TENANTNAME . <br /> ST/�TS/�f2.E' 4'-'l�1�-��L�� �l u-���f-2R��1 l _ <br /> CONTRACTOR ADDRESS ZIP CONTR.LICENSE� <br /> 21lItiEf���' �1V�L C� 11 Zo�1 �11GuN��+KE ffESt�ncR w1 �lix=`t3 <br /> c{-vMP.rc N�'c�IAuscA� :fN': O�:(�tPiwrl,��'01 <br /> PHONE � 1.2�7" 77�I- ��I � !. <br /> PROPOSED USE OF BUILDING Bwlding Mechanical �Atldition HEAT SOURCE � <br /> � PERMIT � Combinatio Plumbing WORK Alteretion '�I�3 ElecUic g <br /> ;YPE Demolition Sign TYPE �epeirlMaint. v Other � <br /> ��,QJ���}L LLL(�.lL. Sprinkier �j <br /> CONTRACT PRICE OF WORK ��'7 '�r��' CITY OF EVERETT LOCAL SALES TA%CODE�S 3105 � <br /> WORK�ESCRIPTION ��NS-T�C.L �.�� �T4�1 �.1-1�('%"(J�GN Sy�����"� ��C)�. /'l�V � <br /> •'v"..�.GSTTNc� F�Y;i-TdP �tiu.:.T . -y�,15iP�c.c.. nlJD vF�vT `! Etiif/i�si ���vS�- i <br /> v <br /> UfiN� Or�C D;-y('t2 <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIY.TURE OR ITEM NO. TYPE OF FUfTURE OR ITEM j <br /> WATERCLOSET � �C AIC-AIHANDLINGUNITS �, <br /> BATHTUB (G� ����� \_ FORCEDAIRSYSTEMS .7��a;� SYsi�P" 1 <br /> LAVATORY(WASH BASIN) Q� •�� _._ HEAT PUMP <br /> SF'.OWER ��' �� �`(� ._ UNIT HEATERS <br /> KITCHEN SINK 8 DISPOSAL �'� k'� � _ CLOI'HES DRYER <br /> DISHWASHER Cj� ���1� � _ �NGE HOOD � <br /> LAUNDRY TRAY _ WnTER HEATER <br /> CLOTFIES WASHER '�� �G� � _. METAL FIREPLACE/STOVE i <br /> .— G� ��� FIREPLACE INSERT <br /> URINAL ��C• �� GAS FIREPLACE <br /> DRINKING FOUNTAIN �� � GAS RANGE <br /> FLOOR DRAIN GAS PIPING <br /> BACKFLOW PREVENTER� � EXHAUST FAN <br /> SINK(SERVICEIBARIMOP/ETC.) OTHER <br /> OTHER — <br /> I HEREBY CERITIFY THAT I HAVE READ AND EXAMINED THIS APPLICATIQN AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br /> PROVISIONS OF U1W5 AND ORIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETFIER SPECIFf[D HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOIATE OR CANCEL TME PROVISION OF ANY OTMER <br /> STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZE�BY THE <br /> OWNER OF TMIS PROPERTY TO PERFORM'i HE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRAC7�S LAW 18.27 RCW AND 29620D WAC. <br /> �j��� �;� �� - ���� � <br /> Sig� uf o�C wSadContracrodAuthonzed Agent Dete <br /> I DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> t <br /> J <br />