Laserfiche WebLink
PER11011T APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 92201 <br />425-257-8810 — FAX 425-257-8857 <br />SITE ADDRES`�,�� _\�,��\ I\v� �U • <br />� <br />LEGA LOT NO. � - <br />DESC. .� <br />OWNER <br />��C(LECI� ,I NG. <br />TENANT NAME <br />N/� <br />CONTRACTOR <br />P40NE J A-�� <br />PROPOSE� USE OF BUILDING <br />S o ��a � O <br />CONTRACT PRICE OF WORK <br />WORK DESCRIP�TtION <br />P l t�h.� Ty � Z �� <br />��,� Z231 <br />k <br />�� <br />O L� rhrJ L�c)tRy � STR1�`T <br />� yi0 Sl�y�-1L SP/�+�/as.WAi� STANuIodP <br />CONTACT NAME (4 z5 r�y PHONE GG� . <br />QA�EGf���+3�-� 33y-5935, 3ay•5�a�, 'S30 •2�FLG � <br />N0. I TYPE OF fi%TURE OR REM <br />� WATER CLOSEr (TOILE� <br />2 BATHTUBt <br />� LAVATORY (WASH BASIN) <br />SHOWER <br />1 KITCHEN SINK 8 DISPOSAL <br />� DISHWASHFR <br />LAUNDRYTRAY <br />� CLOTHES Wr:SHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTER <br />_ SIMK �SERVICE/BAR/MOP/ETCJ <br />_ OT�ER <br />oz/ <br />1n/A �BZ9L <br />ADDRESS <br />(� Building Mechanicai <br />PERtAfT j7 Combination � Plumbing <br />TYPE � Demolition Sign <br />Sprinkler (u ol heeds) <br />ZIp CONTR. IJCENSE M <br />Gv�pcljfo3t�NU <br />L-YP. XD�L2��3 <br />D Addition HEAT SOURCE <br />WORK L)IAlteration � �lecltic <br />TYPE «-New es <br />C Repair/Maint . Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 310.5 <br />r <br />NO. I TYPE OF FIXT�iRE OR ITIEM <br />A/C - A/HANDLING UNITS . , <br />FORCED AIR SYSTEMS --- - <br />HEAT PUMP <br />UNIT HEATERS <br />CLOTHES DRYER <br />RANGE HOOD �` �" <br />WATER HEATER <br />MEfAL FIREPIACE/STOVE <br />FIPEPLACE INSERT <br />GAS FIREPLACE <br />GAS RANGE � �� <br />GAS PIPING <br />EXHAUST FAN /� � <br />OTHER (�„1 J <br />�,r �r� <br />I HEREBY CEaITIFY THAT I HAVE READ AND IXAMINED THIS APPLICATION AND KNOW THE SAh1E TO BE TRUE AND CORRECT. ALL <br />PP.G`JISIOt1S OF IAWS AND ORIDINACES GOVERNIDJG THIS TYPE OF WORK WILL BE COPAPLIED WITH WHETHER SPECIFIED HFREIN OR <br />riG' THE ��PaNTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIC�: OF ANY OTHER <br />STATE OR LOCAL LAN' HEGULATING CONSTRUCTION OR THE PERFOflMANCE OF CONS7RUCTION. THAT 1 AM AUTHORIZED BY THE <br />ON/HER OF T PROPERTY TO PERFOFM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CUNTRA ORS W 7827 RCW AND 296200 WAC. <br />/ / � ��iC,.f�C.<; � /G. �� 3 � <br />Signature of Owner/ContractorfAuthonzed Agent ' Da[e � l <br />