Laserfiche WebLink
P�RMIT ApPLICAT�ON <br />CITY UF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-885? <br />i SITE ADDRESS <br />, � <br />5'13�; - �- <br />LQT NO. I f3LOCK <br />DESC <br />f-I �Qa�(2. � <br />. TENANTNAME <br />RISe�S� �--�..�- <br />I CC TRACTQR <br />� c�0.\f2, C���.¢�.�J'�5 �+ 1.l_� <br />� PHONE � <br />rHurOse� USE OF BU�LDING <br />S��q�r��� PERMIT <br />J TYPE <br />CONTRACT PRICE OF WORK <br />TRACT <br />PARCEL TF�X I.D. # <br />6�1U1 nc,.a � f <br />'qU <br />�L-� ��C'�j � C t�� <br />PERMIT # <br />���03 �/� <br />� <br />iONE I <br />l�lo3a-�Si���S� ��o�a9.4q`6o« �-Ids-i�{3�17 <br />CUNTACT FOR PERMIT <br />�--�-tiJ I��SSI <br />PHONE <br />�{ �$ ' �l'13 -17 ( � <br />ADDRE55 T_Ip CONTR. LICENSE # <br />��o3a-3.���ES� �o�4-�Rtso�a- t�ORr2��o3a� <br />�Building <br />Combinalion <br />Demolition <br />Sprinkler <br />techanical <br />lumbing <br />Sign <br />Additian <br />Alleralion <br />w <br />RepaidMaint. <br />HEATSOURCE <br />Electric <br />s <br />Other <br />CITY OF EVEREI7 LOCAL SALES TAX CODE IS 3105 <br />WORK DESCRIPTION , _ <br />Ccs���i1t;`c.� lar-� 'V.�-c-*� 5-eiu.rrQ_u_"���w+.4�, -M-4sc�-.�" �JsA�� l-1 �G <br />o � <br />�. <br />N0. � NPE OF FIXTUftE OR ITEM <br />� WATER CLOSET (TOILET) <br />d BATHTI;P <br />� LAVATORY (WASH BASIN) <br />! SHOWL-R <br />I KITCHEN SINK 8, DISPOSAL <br />� DISHWASHER <br />� LAUNDRYTRAY <br />� CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR CRAIN <br />BACKFL04V PREVENTER <br />_ SINK (SERVICE/BAR/MOPlETC.) <br />OTHER <br />NO. I IYPE OF FIXTURE OR ITEM . <br />A/C—A/HANDLING UNITS <br />FORCED AIR SYSTEMS <br />HEAT PUh1P <br />UNIT HEATERS <br />CLOTHES DRYER <br />RANGEHOOD 111if[cJ <br />WATER HEATER <br />METAL FIREPLACE/STOVE <br />FIREPLACE INSERT <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUSTFAN <br />OTHER <br />I HEREBY CERITIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />aROVISI0N5 OF LAWS AND ORIDINACES GOVERNIIvG THIS TYPE OF WORK WILL BE COMP�_IED WITH WHETHER SPECIFIED HEREIN OR <br />PJOT. THE�GRANT:NG OF A PERMIT GOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE PROVISION OF ;.NY OTHER <br />STATE OR LOCA� LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRI��TION. THAT I AM AUTHORIZED BY THE <br />OWN'cR UF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRAC70RS LAW 18.?7 RC`.'V AND 296.200 WAC. <br />�'-����—' � � � <br />Signawr� of O�vneuContra oi'4uthorized Agent Date /�— • I <br />DEBIT & CREDIT CARDS ARE NOT ACCEPTED ��/�' <br />� <br />