Laserfiche WebLink
\ <br /> ------> - - - �-1 <br /> P��MIT APPLICATION I <br /> CITY OF EVERETT PERMIT SERVICES i <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-25 i-8810- FAX 425-257-8857 <br /> SITE ADDHESS PARCEL TAX I.D.I PE IT� <br /> Z�7 O� �D(JrN Sr S�L $ 1 7SOGYJOb SUCJO�] �GL�� ��3Z <br /> LEGA LOTNO. BLOCK TRACT � • � <br /> DESC. '� � : ; � <br /> / �P PHONE <br /> O W NER ADORESS I <br /> � ��� $►4R6r�R-A G��F�irH �$�nsr�. R��8 NzS-337-9z�f`� I <br /> TENANT NAME CONTACT NAME PMONE <br /> I kyi� G�iFFirH 337 •9zy'f � <br /> CONTRACTOR ADDRESS 21P CONTR.LICENSE� I <br /> PHONE C�LUnf��L/ �� <br /> PROPOSED USE OF BUILOING f� Budding (7 Mechanical � �Add�uon MEAT SOURCE � <br /> PERMIT �__� Com6ination �_� Plumbing WORK ni�?rai�on �Eiectnc j <br /> TVPE �f Demalition Ll Sign TYPE New Gas i <br /> v Sprmkler P.npa�r 1.18in� Oiher i <br /> I <br /> CONTRACT PRICE OF WORK ,'�/}i — CITV OF EVEREIT LOCAL SALES TAx CODE IS J105 I <br /> (. <br /> WURK OESCRIPTION /� ' I <br /> �j ���?�Gt� c:- ' a�Lret�tri�'ivL/ ; <br /> PLUMBING MECHANICAL <br /> NO. TVPE OF FI%TURE OR ITEM NO. TVPE OF FIXTURE OR ITEM <br /> WATER CLOSET _ NC—NHANDLING UNITS j <br /> B�TH7UB _ _ FORCED AIR SYSTEMS I <br /> LAVATCRY (WASH BASIN) __ HEAT PUMP � <br /> SHOWER __ UNIT HEATERS <br /> KITCHEN SINK 8 DISPOSAI. __ CLOTHES DRYER <br /> DISHWASHER _ RANGE HOOD <br /> LAUNDFV TRAY _ WATER HEATER <br /> CLOTHES WASHER _ METAL FIREPLACE/STOVE I <br /> URINAL _ FIFEPLACE INSEAT <br /> DRINKING FJUNTAIN _ GAS �=1REPLACE i <br /> I �_ FLOOR DRAIN = GAS RANGE i <br /> BACKFLOW PREVENTER GAS PIPING I <br /> SINK (SERVICEiBAR/MOP�ETC.) __ EXHAUST FAN <br /> OTHER _ __ OTHER __ <br /> I1 HEREBY CERITIFV TMAT I NAVE READ AMD ErAMIMED THIS APPLICATION AND KNO'.Y TME SAME TO BE TRUE AMO COARECT. ALL <br /> PROVISIONS OF I.i1VJ5 ANOOFIDINACES GOVEPNING 'HIS TYPE OP WORK WILL BE COMPUED WIiH WHEfHEF SPEGFIED HEREIN OR i <br /> NOT THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CAMCEL TNE PROVISION OF ANV OTHER <br /> i STATE OR IOCAL LAN/REGUL4TING CCNSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION THAT I AM AUTHOAIZED B�THE I <br /> OWNER OF THIS PROPERN TO PERFORAI THE'NORK FOA WHICH APPLICATION IS MADE AND I C061PLY WITH THE S?ATE I <br /> IJONTRACTORS LAW tB 27 RCW AND 296..'00 WAC. � <br /> Signolure ol OwnevConlraclonAulhorizetl Agenl ate �/� <br /> � � <br /> � J <br /> �------ ------ <br />