Laserfiche WebLink
PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810- FAX 425-257-8857 <br /> SITEADDRESS I PARCELTAXI.D.A I PER�Pp�(p.� <br /> /OS�3� /5 '~�� Sd �x <br /> LEGA LOT NO. BLOCK TRACT <br /> DESC. <br /> OWNER � ADDRESS ZIP PHONE <br /> Jv�v� /"���� S73/ Zoo�`�Sw �/z 5po36 rqZSJ-7�1`�/ �080 <br /> TENAN/T/NA/�u1E , (/� I ,CONTACT NAME PHONE <br /> � /i//�.� L�Y / 1AA./X//y /'/l J <br /> COMRACTOR ADORESS LP CONTR.UCENSE� <br /> PHONE <br /> PROPOSED USE OF BUILDING Building f'1 Mechenicei Addillon HEA7 SOURCE <br /> PERMIT B Combinetion �_� Plumbing ti;IORK Allaralion R Eleclric <br /> /J_ � � TYPE B Demolition LJ Sign TYPE. New �{ 6as <br /> �'lF/.14LU✓ Sprinklef Repeir/MeinL LJ Olher <br /> CONTRACT PRICE OF WORK CITY OF EVERETT LOCAL SALES TAX CODE IS 9106 <br /> WORK DESCRIPTION <br /> ���;� 3�� 2� v�-s� <br /> 9�z�8' <br /> ' PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TVPE OF FIl(TURE OR REM <br /> WATER CLOSET A/C—A/HANDLING UNITS <br /> BATHTUB FORCED AIR SYSTEMS <br /> LAVATORY(WASH BASIN) _ HEAT PUMP <br /> SHOWER UNIT HEATERS <br /> KITCHEN SINK& DISPOS�AL CLOTHES DRYER <br /> DISHWASHER RANGE HOO� <br /> LAUNDRY TRAY WATER HEATER <br /> CLOTHES WASHER _ !v1ETAL FIREPLACE/STOVE <br /> URINAL FIREPLACE INSERT <br /> DRINKING FOUNTAIN GAS FIREPLACE <br /> FLOOR DRAIN GAS RANGE ' <br /> BACKFLOW PREVENTER GAS PIPING <br /> SINK(SERVICE/BAR/MOP/ETC.) _ EXHAUST FAN <br /> OTHER_ _ OTHER <br /> �` lrre...�. I r.-�a <br /> I HEREBY CERITIFY THAT�HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br /> PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TYPE OF WORi(WIIL BE COMPLIED WITH WHETHEF SPECIFIED HEREIN OR <br />� NOT. THE GRANTING OF A PEFMIT 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 AUTHCRIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 18.27 RCW AN�296.200 WAC. <br /> Signalure ol OwnedContraclodAuthorized Agent Date <br />� --------.�. <br />