Laserfiche WebLink
� <br />SITE ADDRESSy� � <br />� i00 (g �V <br />LEGAL LOT NO. <br />DESC. / G <br />� � <br />PE�i1VIIT APPLICAYIO{� <br />CITY C�F EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVEFIETT, WA 98201 <br />425-25'-8810 - FAX 425-257-8857 <br />W •- �V � <br />PARCEL T.1iC I.D. �! <br />OO���UGpD(oi�iO3 <br />@LOCK � TRACT I <br />FEFMIT n <br />C �c2D/—b/ <br />`� iri-W 1-�' T-e � s' �� �c� c1 �l� c� I 8'� �4V w, L'V. '�G � 3 s5'— C� � 5' � <br />TENANTNAME CONT4CTNAME PHONE <br />I�' l�—e tti. <� L�r.L �,�-'9-s�— 5c�! — I 5 3/ <br />CONIRACTOR�`���� ��_� AODRE55 �G�( ��'7 3� /�V, j•L-ZIP CONTfl.LICENSEd <br />�v w�'� ?s���-c� �G.eN,oia� c>�G'�.T�- <br />PHONE n <br />.. . _ C l�/ " �'�� l�'/� <br />PROPOSED USE OF BUILDING <br />5li!(�rLE FA r-U�Y <br />�� ��D'7� c� .t2!( P cp <br />CONiRACT PRICE OF WORK <br />WORK DESCRIPTION <br />�'.cc�- Noric � <br />�:�. I TYPE OF FIXTURE OR REM <br />PEFiM1T � C�mbination �1 <br />TYPE Demolilion � <br />Sprinkler <br />� r"' � <br />�C917 / � �:' �> <br />Cous-��7 ��E� <br />Jr,TER CLOSET <br />ATh�TUd <br />AVA',-ORY (WASH BASIN) <br />HOh ER <br />ITCF-'EN SINK 8 DISPOSAL <br />ISHWASHEH <br />4U� DRY TRAY <br />LOTHES WASHER <br />RINAL <br />RINKING FOUNTAIN <br />LOOR DRA!N <br />ACKFLOW PREVENTER <br />INK (SERVICE/BAWMOP/E'i C.) <br />THER <br />MeChaniCel 4ddition HEAT SOURCE <br />Plumbing WORK Allcration [� Electric <br />Sign 1VPE New (.,P, �i Gas <br />IFepaidMainl. U O�her <br />CITY 7F EVERE'� T LGCAL SALES TA% CODE IS 3705 <br />��USE � ( `a Z�.. S.F. <br />«�z� a-rra��+�� �a na�e � � �o s,F <br />� <br />NO. � TYPE OF FIXTURE OFi ITEM <br />^_ A!G — A/hIANDLING UNITS <br />� FORCED AIR SYSTEMS <br />HEAT PUNP <br />UNIT HE.4TERS <br />X CLOTHES DRYER <br />RANGE HOOD <br />�WATER FIEATER <br />METAL FIREPl,10E/STGVE <br />� FIREPLACE INSERT <br />� GAS FIREPIAC[ <br />GAS RANGE <br />GAS PIPING <br />EXHAUST FAN <br />_ OTHER <br />I HEREBY CERITIFY THAT I HAVE RFAD AND EXAMINED THIS APPLICATION AN� KNOW THE S.4ME TO BE TRUE AtJD �.ORRECT. ALL <br />PHOVI510�^1S OF LAWS AN� ORIDINACES GOVERNINu TNIS TYPE OF WOqK WILL BE COMPLIED WITH WHEfHER SPEi,IFIED HEFEIN OF <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br />STATE OR LOCAL LAW REGULATING CONSTFUCTION Ofi THE PERFORMFNCE OF CONSTAUC710N. THAT I AM AUTHOFlIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS hL1DE AND I COMPLY WITH THE STA�iE <br />CONTRACTOFjS LAW 1.2�}3ChV AND 296.200 WAC. <br />- a- <br />