Laserfiche WebLink
I, �- ' � � _ <br /> PERMIT APPLICATION � <br /> CITY OF EVERETT PEF�MIT SERVICES � <br /> 3200 CEDAR STREET, EVEREiT, WA 98201 ' <br /> 425-257-Bb10 — FAX 4�5-257-8Ef57 <br /> _ �� ,�b S-6�� <br /> � <br /> , <br /> SITE ADD SS RCEL TAX I.D M PERMI7 H � <br /> -�il��� - I�o� �. l� . �_�C l��`��,� �;-��,c� �� �� _ ��� �s—or � ' <br /> DESC. LOTNO. '� BLOCK I �R{�CT�1 �_\�\1VECJ��\- 1 l�`�����`C . <br /> � \ \ <br /> OWNER ADDRESS ) ZIP PHOME , <br /> Cc�� C�lcr.�. in�c�. .\'\������.�E_� C��_�til���a��l,g\P;:,�:,`��,��, W� ����i�a\�. � <br /> 7EN*N7 NAMG CONTACT NAME (Lt�C�\ �-nk PHONE l��� � <br /> \` ` ) <br /> \v �� C ���\R�LC ' '}1�r �`�� 3�-4.r,c� �z ` � �� � i <br /> �� �.�� � � <br /> CONTRACTOR ADDRESS LP C���I�G��1\�C\ I <br /> PHONE �(�n <br /> � 1`�\� - 1�. �� ' I <br /> PROPOSED USE OF BUILDING Building Mechanical Addition IiEAT SOURCE <br /> � .`. � AERMI7 Combinetion��Plumbing WORK � Allarelion Elecltic <br /> � TYPE DCm01iti0n Sign TYPE Naw Ges I <br /> � Sprinkler(a ol heads) Repaf�/Maint. Other <br /> CONTRAC'f PR'CE OF N�ORK CITY OF EVFRETT LOCAL SALES TAX COUE IS 3105 <br /> WORK DESCR�PlION I <br /> ����h� \���) <br /> � <br /> ��\�S�C �a�=�� '�v <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> WATER CLOSET(TOILET) _ A!C—NFIANDLING UNITS ; <br /> BATHTUB _ FORCED AIR SYSTEMS I <br /> �_ LAVATORY (WASH EASIN) _ HEAI'F'UMP I <br /> SHOWER UNIT hIEATERS <br /> J_ KITCHEtJ SINK& DISPOSAL � CLOTIIES DRYER <br /> �_ DISHWASHER � RANGf_HOOD <br /> I_AUNDRY TRAY � WATER HEATER <br /> � CLO'HES WASHER METAL FIREPLACE/STOVE <br /> _ URINAL �IREPLACE INSERT <br /> = DRINK�Nr, FOUNTAIN � GAS FIRFPLACE <br /> fLOOR DRAIN GAS RANGE <br /> _ BACKFLOW PREVENTER � GAS PIPING <br /> _ SINK(SERVICE/BAR/MOP/ETC.) _ EXHAUST FAN <br /> _ OTHER _ OTHER <br /> I HEREBY C[RITIFY TFIAT i HAVE HEAD AND EXAMINED THIS APPLICATION AND KNOW THI:SAME TO BE TRUE AND CORRECT. ALl <br /> PROVISIONS OF L1WS AND ORIDINACES GOVERNING THIS TYPE OF WORK 1NIlL BE COAIPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTIiORITY TO VIOLAT�OR CANCEL THE PROVISION OF ANY OTHER <br /> STATE OR LOCAL LAW REGULf�TING CONSTRUCTION OR THE PERFURMANCE OF CONSTF;UCTION. THAT I AM AUTHORIZEO BV THE <br /> OWNER THIS PROPERTY TO PERFORM TNE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONT AC RS LAW 78.27 RC AND 296.200 WAC. <br /> �/,'�-1��� I/l�/> ; <br /> SignaWre ol OvmedContraclorlAulhor¢ed Agent Dale �/ <br /> v <br /> � <br /> — --___ —; <br />