Laserfiche WebLink
1 <br />, t <br /> PERMIT APPLlCATION � <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810-FAX 425-257-8857 <br /> SITE ADDP.ESS PARCEL TAX I.D.# PERMI7# <br /> � I +-�- /��tC S � � „ , __ <br /> _� S/�. - �r,� <br /> -� <br /> LEGAL LOTNO. BLOLK TRACT <br /> DESC.� _ <br /> OWNER ( ADDRESS ZIP PHONE <br /> t�0.T�1'i�\ ��E�l G'I�'�W��_ 1'C) Qc.x ��� suc)�..,.f54 C��.�n{O �U-jj 1 ' SC���,' <br /> TENANTNAME CONTACTFORPERMIT PHONE <br /> s���u-� l�k�� ('��<<� ��„li � y���� 36� � N2`t-i32s� <br /> 1C�,,O�NTRACTOR 1 J n /AODRE/SIS / ZIP CONTR.LICENSE# <br /> U�'lf'-�� �(�� Y �C�l��� risl{K\ oCUU�.� Ylwy��SGU r� �C1i-��.� �����'� <br /> PHONE ��:�' �.2.�� 13�� J �8,'1.��j �MeY�kr'�o36�� <br /> PROPOSED USE OF BUILOING � BUilding �MeChaniCal I n Addition HEAT SOUFCE <br /> �_ PERMIT Combination Plumbiny- .:ORK �--5 Altcration n Eleclnc <br /> 11�/i VI ��_���� l TYPE Demolition Sign TYPE;�F�New j_� Gas <br /> Y�< < Sprinkler LJ Rep�irlMain�. Ll Other <br /> CONTRACT PRICE OF WORK S�Y,[)�s�- CiTY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I <br /> WORK DESCRIPTION <br /> i��5-��,�� � s ����� ��� �e �� s��v�y ����-��r� <br /> PLUMBING \ MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. NPE OF FIXTURE 012 ITEM <br /> WATER CLOSET AIC-A/HANDLING UNITS <br /> BATHTUB FORCED AIR SYSTEMS <br /> LAVATORY(WASH BASIN) HEAT PUMP <br /> SHOWER UNIT HEATERS <br /> KITCHEN SINK&DISPOSAL CLOTHES DRYER <br /> DISIiWASHER RANGE HOOD <br /> LAUIJDRY TRAY WATER HEATER <br /> CLOTHES WASHER METAL FIREPLACE/STOVE <br /> URINAL FIREPLACE INSERT <br /> DRINKING FOUNTAIN GAS FIREPiACE <br /> FLOOR DRAIN GAS RANGE <br /> BACKFLOW PREVENTER GAS PIPING <br /> SINK(SERVICE/BAR/MOP/ETC.) EXHAUST FAN <br /> OTHER OTHER <br /> I HEREBY CERITIFY'fHAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME i0 BE TRU[AND CORRECT. ALL <br /> PROVISIONS OF LAWS A��D ORIDINACES GOVERNING THIS TYPE OF WORK WILL B[COMPLIED WITH WHETHER SPECIFIED H[REIN OR <br /> NOT. THE GRANTItJG OF A PERMIT OOES NOT PRESUME TO GIV[AUTIIORITY TO VIOLATE OR CANCFL THE PROVISION OF ANY OTHER <br /> STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORM1IANCE OF CONSI'RUCTI04. THAT I AM AUTHORI2ED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM':HE VJORK FOR bVHICH APPLICATION IS MADE AND I CON��LY WITH THE STFTE <br /> CONTRACTORS LAW 1827 RCW/�'��D 296200 WAC. <br /> �(��-�'-{�Z`a-z.�.L,., ���'- �p -o� n <br /> Signature of OwnedCont 6lor/Au horized Agenl Date ,� ,;II (� �� <br /> ' 1 <br /> DE81T& CREDIT CARDS ARE NOT ACCEPTED � ` <br /> � / � <br /> � �7_t�- > <br />