Laserfiche WebLink
5�T[ ADURESS <br />/ � � � <br />LCr3qi-� LO7 NO _..�_. <br />DES�: � '_ <br />OWNER <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDi,R STREET E'dERE�' .�'� �87_G1 <br />42r-257-5810 - F�X 425-25i-8857 -:;vr;: everettwa org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM `g —�%a '�'� 7 <br />--- <br />� PARCEL TAX i.D. a PERMIT N <br />��,5 /7{ S I .SIIJ Il. U ) i`, ) . , <br />--- �-- -- --- ---� -�-- <br />BLOCN TRACT <br />` � AODRESS CITVi117 PMONE <br />ia<�A�i� �N�uzi�� �s�-5 <br />TCNANTNAME <br />CONTACT FOR PERMIT <br />PHONE <br />CONTRACTOR � ��— -- ��— ADORESS CITYIZIP PF10NE �—�� ���� <br />,��,�,�,s �,� n� �.,�g,,,.�. <br />Z.q�.ju /LYn. A�e' ARei...�Vrs... .dFi�` Vo'S ��tl. <br />r;ir�ra LiCENSEN QQ�)��F,n�2�L�L r�C __ <br />USF OF BUILD�NG , HEAT SOURCE �, CONTRACT PRICE OF WORK <br />.$ (' /1- __ E ect� c_ �as __ J;.'e' <br />,3ono.�+�� <br />WORH DESCRIP7IUN <br />,. �,i �ll. L { .�.'� S/�iJi.vs�a.L-7� /i" �.-C ).�' Sr��� <br />� <br />PLUMBING <br />T1'PE UF f I�TUAF OR ITEM <br />Todet <br />A2thtuh <br />�a�alory (wash basin) <br />ShOwer <br />Kdehen Sink f� d�5po581 <br />DiShw35hB! <br />i Ciothes washer <br />� Launtlry tray <br />I S�nk �serv�ce'barmop�etc 1 <br />I 0ackllow preventer <br />Unnal <br />� (N�nMmy Fountain <br />FUor tl�a�n <br />: �rp350lydp <br />Roof drains <br />Uth2f <br />i <br />� <br />� MECHANICAL <br />HO TYPE OF fIXTURE OR ITEM <br />�--- --a-�,. , - -� -� ---- - <br />--� vo.:e�a�';,s'_.:�.. <br />i�BS C G �y <br />l'Jater hee!e� <br />Gas �,re0iac- <br />_� Gas �a^�9e <br />CIOI^E+ tl'.='� <br />—I Ga�yc <br />Ea^�a_:•' . <br />H@et c . . <br />U^n , <br />I <br />6o ie' <br />ReP _e . <br />� �I::,:os�.. <br />`' E __"_ <br />ZQ S/�R�Nr��� ��lA(iS <br />� CIT�OFEVERETTLOCALSALE57A%CODEi51105 <br />��,�by cerrtJy tnat I nave reatl an� eram���eo r.s apH���ano"� aro kno�a tre sa�e !� oe tr„e an� correct A'�� prov�s:ons ot iaws an� <br />�,.ve5 goveming ihis type of wo/k wdl be cc^'p���etl'•ti�lh w�e!ner SpeC'�eo 7ere ^ c' ^C! Tne g�anurg o� a perm�t tl0e5 nol pre5ume <br />.�. aUIhOf11y �O Vi01810 �� Cdt1CP' �hP Pfp'.�S Or Jf d^� JI�.e� 5'd:P C JCd .d:�'P... ?. _:"5".::: .' :hP F2f!p!TB�CB 0� <br />...�cbon 7hat I am a�ihonzed bv !ne c�tire, �� tn.s c��CertY tc :e.,z.^ c�e v. - �• � � _ . . _ . ., a.;� a�� 7 i c_^�t �.. :. , , . <br />�.�:: omraciors Law 18 27 RC�' a �5f :�' �'+F.: <br />• , • `���..t. �:,...,;,zeoA.�ert N 2,3/l%c __ 1 <br />�� <br />