Laserfiche WebLink
i <br /> j PEf�MIT APPLICATION <br /> i CITY OF EVERETT PERMIT SERVICES � <br /> � 3200 CEDAR STREET, EVERETf, WA 98201 I <br /> i 425-257-8810- FAX 425-257•8857 <br /> I <br /> I SITE ADORESS / PARCEL TAX 1.0.N ., P RMiT♦ <br /> ��� �Qr� J� - 7� Gu ( �� d6U OO;jO � �� �la - �lS <br /> ILEGA LOT N0. � BLOCK TRACT 1 ]� <br /> DESC. ,} t 1 5 C v�y�0 w c.� Cc,w r 1 <br /> OWNER AODRESS ZIP PHONE 33�7-b5G( <br /> /I/Dr��n�a F��i��c aGo � ��� 1_"l� .�f-.SC Cv..2/I� 9rY `/�S 3a�-d3yl <br /> �'ENANT NAME CONTACT NAME PHONE 3 j7-6�b � <br /> _��L39E /�S /�l3od[= �i-w1ct�� yas 3� � - g3Y1 <br /> CONTRACTOR ' t S �(j0 Ut ADORESS ZIP CONTR.LICENSE M <br /> :�+m - � <br /> PHONE <br /> PROPOSED USE OF BUILOING Bwlding Mechanicnl Addmon HEAT SOURCE i <br /> I PERMI7 � Combinalion � Plum6ing IWORN R Allereli0n I � Electnc <br /> � i1�V��� TYPE OemolAion d Sign TVPE R New Gas <br /> �r� Sprinkler LJ Rppainblaint Other <br /> CONTHACT PRICF.OF WOFK CITY OF EVERETT LOCA�SALES TA%CODE IS 3105 <br /> WORK DESCRIPTION <br /> PLUMBING MF.CHANICAL <br /> NO. T'PE OF FI%TUHE OR ITEM N0. TYPE OF FI%TURE OH ITEM <br /> � WATER CLCSE7 11C —NHANDLING UNITS <br /> I BATHTUB FURCED AIR SYStEMS <br /> i� LAVATORY(WASH BASIN) _ HEAT PUMP <br /> SHOWER UNIT HEATERS i <br /> , KITCHEN SINK 8 DISPOSAL CLOTHES ORYEF � <br /> I = ,..SHWASHER _ FANGE HOOD i <br /> , LAUNDRY TRAY VlATER HEATER <br /> � CLOTHES WASHER METALFIREPLACE/STOVE <br /> i _ URINAL _ FIREPLACE INSERT � <br /> DRINKING FOUNTAIN GAS FIREPLACE <br /> FLOOR DRAIN GAS FANGE I <br /> � �ACKFLOW PREVENTER GAS PIPING j <br /> �. ,_ SINK �SERVICE:�AF/MOP/ETC.) EXHAUST FAN i <br /> OTFIER _ OTHER <br /> i HEFEBY CERITIFY'HAT I HAVE READ AND E%AMINED THIS APPLICATION AND KNOR'THE SAME TO BE TRUE AND CORRECT. ALL <br /> PROVISIONS OF LAWS ANU ORIDINACES GOVEFNING THIS TVPE OF WORK WILL BE COMPUED WITM WHETHER SPECIFIED HEREIN OR <br /> NOT P+E G�ANTiMG OF A PERMI7 DOES NOT PRESUME TO GNE AUTHOFITV TO VIOLATE OR CANCEL THE PROVISIUN OF ANV OTHER <br /> 5 rqTF OR LOCAL LAW REGULATING CCNSTRUGTION OR THE PERFOPMANCE OF CONSTRUCTION THAT I AM AUTHORIZED BV THE I <br /> O'.VNEA OF TMIS PFOPERTV TO PERFORM THE WORK FOR WHICH APPUCATION IS h1ADE AND I COMPLV WITH THE STATE ( <br /> CONTRACTORS lAW �827 RC4V AND 296.^.0,j�WAC <br /> i �.4Ai��,tdy2 ��o L�C.I ��2 ' /0 'D � ,fJ I <br /> S(gn� a'�re ol c�wneoConlrac�or Aul�Agent ala �;�`f���J� I <br /> I '� �L <br /> � - - <br />