Laserfiche WebLink
SITE ADDRESS <br />�1 �-1 /��') 1 h� <br />LOT NO. <br />DcSC. <br />PERMIT AF'PLICATION <br />C1TY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVER�TT, WA 9820� <br />425-7_57-8810 - FAX 425-2C 7-8857 <br />BLOCF; I TRACT <br />PARCEL TAX L0. # <br />/�'1r 9 `oc5 Ne I1I(v"` ,�i. Ki�Ytw.,(,',wA q55c3,j - <br />�Cl(,�:[.,��V'�J1 Cn'JrIO.��h�J�n 11Gm� lM'V:...� AJk'L� <br />TENANT NAS1E I CONTACT FOR PERMIT PHONE _ <br />i� / � _ <br />CONTRACTOR ADDRESS I <br />� J��;� �ouak.,�..1 �nmpn� <br />PNONE <br />�I��zs����-_3�� ��. ���. la.���f— C, <br />PROPOSED USE OF BUILDING Building D Mechanica� <br />PERMIT �Combinalion U Plumbing <br />TYPE Demolition U Sign <br />G�'��� ""4` °'� � Sprinkler <br />CONTRACT PRICc OF WORK �1f ' . j' / <br />`�-�-'-t��''� _' <br />WORK DESCRIPTION p n �,w <br />���q.� :J'it.�J' �n�tl� /lµ� `j.. Csl� WuL��S c� bJi,U�nJ�'.,�11,�,���. /�. <br />CJ � <br />LICENSE # <br />(17SiwACr_.'�'-1C� �Z. <br />G �' <br />���, �; 8 � . __ �r_� <br />Additian HEAT SOURCE <br />WORK Alteration Electric <br />7YPE New Gas <br />P,epairlMaint Other <br />CITY OF EVERE7T LOCAL SAI.ES TAX CODE IS 3105 <br />NO. � TYPE OF FIXTURE OR ITEM <br />WATER CLOSET (TOILET) <br />BATHTUB <br />�AVATORY �WASH BASIN) <br />:HOWER <br />KITCHEN SINK & DISPOSAL <br />DISHW'ASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAI_ <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTER <br />SINK (SERVICE/BAWMOP/ETC.) <br />OTHER <br />NO. I i 7PC- OF FIXTURE OR ITEM <br />4/C — A/HANDLING UNITS <br />FORCED AIR SYSTEMS <br />!1EAT PUMP <br />UNIT HEATERS <br />_I CLOTHES DRYER <br />RANGE HOOD <br />WATER HEATER <br />METAL FIRE?LACE!STOVE <br />FIREP! ACE INSERT <br />GAS FIREPLA:E <br />GASRANGE <br />GAS PIPING <br />EXHAUSTFAN <br />OTHER <br />I HEREBY CERITIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOIN THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF IAWS AND ORIDINACES GO�ERNING THIS 71'PE OF WORK WILL OE COMPLIEC WITH WHETHER SPECIFIED HEREIN CR <br />NOT. THE GRANTING OF A PERMIT DOES NO— PRESUME TO GIVE AUTHORITY TO b'IOLATE UR ��ANCEL THE PROVISION OF ANY OTHER <br />STATE OR LOCAL LAW REGULATING CONSTRJCTION OR THE PERFORMANCE OF CCNSTRUCTION. 7HAT I AM AUTHORI2ED BY TNE <br />OWNER OF T�{IS-RjtOPERTY TO FERFORM TH'c WORK FOR WHIC4 APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTy1RS LA�V 1&.27/RQ6V�WD�96.2001VAC. <br />DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />