Laserfiche WebLink
F �:RMIT APPLIGATI._. N <br />CITY OF EVERETT PE�iMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 <br />SITE ADDtiESS � l�-� F'8 T{'L . <br />� � <br />LEGA LOT� LOCIS <br />DESC. S <br />A ER <br />I�c� t� �_ �v -�-�� <br />TENANT NAME <br />CO. RACTPR ��, <br />C� � <br />PHONE �r��` -tir-� , �, , _ . <br />PROPOSED USE OI' BUILDING <br />�C��\ <br />CONTRACT PFICE OF WOFK <br />PARCEL TAX I.D. � <br />' � <br />TRACT �l� ^ <br />VI <br />ADDRESS <br />v�.vv 2 9 I g G' <br />NTACT NAME <br />PERMIT N <br />Q�J <br />�zr 2sz- <br />ADDR S,� 1,^.� I`1V� /�n.��,hlp CONTR. ICENSE p <br />� � WCi� `�'GL7t�1 �s ��� IIS DT <br />Building Mechanical rV� Addition HEAT SOUFCE <br />PERMIT Combinalion � Plumbing WORK �) Alteretion pi Electric <br />TYPE Demolilion Sign 7YPE � New H Gas <br />Sprinkler Repair/Pdaint LJ Other <br />J,� `� /�/ ��l' CITY OF EVERETT LOCAL SALES TAX COOE IS 3105 <br />WORKD'cSCRIPTION n,n�(�tc�-�M � �r��� '�t,�� ( l <br />r'IYJr� 1 ' w � (, � '�`j( <br />e��= �.�o � � � � � �n ,�,- 3 0�4 <br />NO. I TYPE OF FIXTUFE OR ITEM <br />WATER CLOSET <br />9ATHTUB <br />_ LAVATORY (WASH BASIN) <br />SHOWER <br />KITCh�EN SINK 8 DISPOSAL <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTEH <br />SINK (SERVICE/8AR/MOP/ETC.) <br />I HEFEB'/ CEFITIFY <br />PROVISIONS OF LA� <br />N07. THE GPANTIti <br />S7ATE OR LOC�YL L� <br />OWNER OF 7IjIS PR <br />� <br />NO. � TYPE OF FIXTURE OR ITEM <br />A!C —A!l;ANDLING UNITS <br />FORCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT HEATERS <br />CLOTHES DRYER <br />RAIJGE HOOD <br />WATER HEATER <br />METAL FIREPLACE/STOVE <br />FIREPLACE INSERT <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUSTFAN <br />OTHER <br />jAT I HAVE READ AN EXAMINED THIS APPIICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />i AND ORIDINACE�G VEFNING THIS TYPE OF WORK WILL 8E COMPLIED WITH WHETHEP SPECIFIED HEflEIN OR <br />OF A PERbtIT DOES N�T PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHEA <br />! REG�J YJ9TING,CONSTk�UCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED 6Y THE <br />'ER7N T PE�iFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />��z`i R �A D 296.200 W <br />�_—�1'��;�-� � ��. , o- o�— <br />�/a <br />