Laserfiche WebLink
r ,� � `� <br /> PEFiMIT APPLICATION � <br /> CITY dF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810- FAX 425-257-8857 <br /> Pw �i� - 6a� <br /> SITE ADDRESS pARCEL TAX I.D.M PEFMI7 a <br /> �'� � �! �T`� I�u� �n/ iaa 8oy 3oa2 c�oa� (�m/�m� <br /> LEGA LOT N0. BL CK TRACT <br /> DESC. �' � <br /> OWNER ADDRESS ZIP PHONE <br /> .SUST jj;�� CunSiructiun �o t�� ao�/ 3 Euucf+ 98203 �/15' 3�8 •3l� `/ � <br /> TENANTNAME CONTACTNAME PHONE <br /> CONiRACTOR T�;jr a;�{. CunS7rvCMc� pDDRESS ZIP CONTR.LICENSEN <br /> �.U. �CX oZ0��3 k�Kff Se1a3 <br /> PHONEZIaS - ,30 ' 3�7 �1 <br /> �'i 3'us�Rc+ko�l13G <br /> PROPOSED USE OF BUILDING Building Mechanical Addition HEAT SOURCE <br /> PERMIT � Combination R Plumbing WORK � Alleralion � Electric <br /> TYPE Demolilion � Sign TYPE New Gas <br /> Sprinkler Repuir/Mainl. Olher <br /> CONTRACT PRICE OF WORK CITY OF EVERE7T LOCAL SALES TAX CODE IS 3105 <br /> WORKDESCRIPTION ��.; ��I a TP:PI�K <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF FI%TURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> � WATERCLOSET A/C—A/HANDLINGUNITS <br /> BATHTUB � FORCED AIR SYSTEMS <br /> � LAVATORY (WASH BASIN) EAT PUMP <br /> 3 SHOWER U HEATERS <br /> 3 KITCHEN SINK 8 DISPOSAL � CLOT DRYER <br /> � DISHWASHER � RANGE H <br /> LAUNDRYTRAY � WATER HEATE <br /> 3 CLOTHES WASHER METAL FIREPLACE/ VE <br /> _ URINAL FIREPLACE INSERT <br /> _ DRINKING FOUN IN � GAS FIREPLACE <br /> FLOOR DRAI 3 GAS RANGE <br /> BACKFLO PREVENTER 12 GAS PIPING <br /> SINK RVICE/BAR/MOP/ETC.) I� EXHAUST FAN <br /> _ OT R _ _ OTHER <br /> I H[RE6Y C[fiITIFY THAT I NAVE READ AND EXAMWED THIS APPLICATION AND KNOW TNE SAME TO BE TRUE AND CORRECT. AlL <br /> PROVISIONS OF LAWS AND ORIDINACCS GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHEiHER SPECIFIED HEREIN OR <br /> �:OT. THE GRANTING OF A PERMI7 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br /> ;TATE OR LOC�L LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br /> OVJNER OF T!iIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH TH[STATE <br /> CONTRACTOR AW 1P27 RCW AND 296.200 WAC. <br /> Y� ���/ /�-�3•UI <br /> Signalure ol Owner/Conlraclor/Authorized Agenl Date O <br /> 1 � <br />