Laserfiche WebLink
f-- � — � <br /> ' PERMIT �4PPLICATION ' <br /> CITY OF EVERETT PERMIT SERVICES I <br /> 3200 CEDAR STREET, EVERETT, WA 98201 I I <br /> 425-257-8810- FAX 425-257-8857 �� <br /> I I <br /> SITE A DRESS �� ARCEL TAX I.D.# PE T a <br /> i� - Il� - r . �J. GC� � dl -ozs- � <br /> LEGA LOT NO. BLOCK TRACT <br /> DESC. I, 1 LoC9A�U v�/ S. � I' <br /> OWNER pDDRESS . ZIP PHONE i <br /> Co�o Ca�-sK ra� . I �1 �� S � <br /> _ , , �� ��- �a.�,a u s �ln v , �' T��,,,o,ro , �n/rF 9 t'�z v 2 <br /> 'iENANT NAME CONTACT NAME �4.L5) PHONE <br /> i\.� �la- �A�e FA�r G cr.� <br /> �2tP�6C6 3�N-5135 33y- Sg35 � 330-�yZ�.! <br /> CONTRACTOR ADDRESS ZIP CONTR.LICENSE N 'I <br /> PNONE � � w` � G0 �-pGA 'IFUTjQjAIL7 <br /> GXP. /O�Lz/o3 I <br /> PROPOSED USE OF BUILDING f�, Building � Mechanical I-1 Addition HEAT SOURCE <br /> n PERMIT �_� Combination Plumbing WORK 4_� Alteration �Eiectric <br /> � F f� TYPE �1 Oemo�ifion Sign 7YPE (Ly.Naw Gas <br /> � � ' t LJ Sprinkler(a ot heads) l, RepaidMeint. Other <br /> CONTRACT PRICE OF WORK CITY OF EVERETT LOCAL SALES TAX CO�E IS 3105 <br /> WORK�ESCRIPTION <br /> (�,_��., � l 4�0 <br /> \'_,-, :. _ zz �c� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> "� WATER CLOSET(TOILET) A/C-A/HANDLING UNITS <br /> L BATHTUB � FORCED AIR SYSTEMS <br /> -�,_ LAVATORY(WASH BASIN) HEAT PUMP <br /> SHOWER UNIT HEATERS <br /> � KITCHEN SINK& DISPOSAL � CLOTHES DRYER <br /> I DISHWASHER 1 RANGE HOOD <br /> LAUNUR` l'RAY I WATER HEATER <br /> � CLOTI1Eo WASHER METAL FIREPLACE/STOVE <br /> _ URINAL FIREPLACE INSERT <br /> DRINKING FOUNTAIN GAS FIREPLACE <br /> _ FLOOR DRAI� 1 GAS RAIJGE <br /> _ BACKFLGVJ PREVENTER � GAS PIPING ��/ <br /> _ SINK(SEP'JICE/BAR/MOP/ETC.) � EXHAUST FAN <br /> _ OTHER __ _ OTHER �0�� <br /> — — — �V " <br /> I HEREBY CERITIFY 7HAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOIY THE SAME Tn BE TRUE AND CORRECT. ALL <br /> PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHFThIEP SPECIFIED HEREIN OR <br /> NOT. THE GRANTIIJCa OF A PERPAIT DO[S NOT PRESU�IE TO GIVE AUTHORITY TO VIOIATE OR CANCEL THE PPUVISiON OF ANY OTHER <br /> STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br /> OWNEF OF THIS PROPERTY TO PERFORM'i HE WORK FOR WHICH APPLICATION IS PdHDE AND I COMPLY WITH 7HE STATE <br /> CONTR,L�70 S LAW 78.27 RCW AND 296.2U0 WAC. <br /> /����.�.�..��� l,�//��s 3 <br /> SignaWre of OwnedConiractodAuthorized Agent Dale <br /> i <br /> � 2 <br /> i <br />