Laserfiche WebLink
P�'RMIT APPLICATIrN <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERE7T, WA 98201 <br />425-257•8810 — FAX 425-257-8857 <br />pU�=���-o�� <br />SITE ADDqESS PARCEL TAX I.D. • PERMR � <br />�<v77 � j �� S.c �x; ��/c7- �.r.,r - �il. -c:r� I C � 30 7 -c��� <br />DESC. <br />! C'�Yll � /�j?��/�f <br />TENANT AME <br />GONTRACTO -Y <br />t^-'� <br />PHpNE <br />PROPOSED USE OF BUILOINf; <br />J�� <br />CONTRACT PRICE OF WORK <br />BLOCK TRACT `-� <br /><�'[/��' i� <br />WORK DESCRIPTION <br />_St �' � <br />�z'/S�C� � � � � ,� <br />INO. I IYPE OF FII(TUHE OR REM <br />-� wAItH[:LUSET <br />� BATHTUB <br />s LAVATORY (WqSH BASIN) <br />SHOWER <br />KI7CHEN SINK 8 DISPOSA� <br />DISHWASHER <br />`,= LAUNDRYIRAY <br />� CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTER <br />SINK (SERVICE/BAR/MOP/E7C.) <br />OTI�ER <br />_7j1/C_ <br />PERMIT <br />TYPE <br />�E� SC� L It�.Siw.N � f'� <br />i l .�....�.-� 1b <br />:1' NAME <br />�/✓.���;��� <br />ADDRESS <br />�Building � Mechanicel <br />Combinalion Plumbing <br />Domolilion Sign <br />Sp�inkler <br />'�Zs =3��1-os J3 <br />PHONE <br />'s_ <br />2IP CONTq. �ICEN9E / <br />��/��7lNG 'lY.F' <br />�Addition HEAT SOURCE <br />Alleratbn � Electrk <br />New I Oee <br />Fepeir/Meinl. Olher <br />CITY OF EVERETT LOCAL SALES TA% CODE IS 3705 <br />NO. � TYpE OF Fl%TURE OR ITEIA <br />A/C - A/HANDLING UNITS <br />FORCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT HEATERS <br />CL07HES DRYER <br />RANGEHOOD <br />WATER HEATER <br />ME7AL FIREPIACElSTOVE <br />fIREPLACE INSERT <br />GAS FIREPLACE <br />GASfiANGE <br />GAS PIPING <br />EXHAUSTFAN <br />OTHER <br />1 HEREBY CERITIFY !HAT I MAVE READ AND EXAMINED THIS APP�ICATION ANO KNOW THE SAME TO BE TRUE AND CORRECt. ALL <br />PROVISIONS OF LA�YS AND ORIDiNACES GOVERNING THIS TVPE OF WORH WILL BE COMPLIED WITH WHETHEF SPECIFIED HEREIN OR <br />N07. THE GRAN7ING OF A PERMIi DOES NOT PRESUME TO QIVE AUTHOR�TY TO VIOUTE OR CANCEL ?HE PROVISION OF ANY OTHEH <br />STATE OR LOCAL LAW REGULATING CONSTqUCTION OR TME PERFORMANCE OF CONSTRUCTIqN. THAT I AM AUTHORIZED BV 7HE <br />OWNER T S P PERTY TO P FOpM,THE WORK FOR WHICH APPLICATION IS MADE AND 1 COMPLV WITH THE STATE <br />coNr� ��e _��gw� zs�joo wac. <br />��: <br />