Laserfiche WebLink
P�RMIT APPLICATI�'V <br />CITY F EVERETT PERMIT SERVICES <br />3^00 CEDAR S7REET, EVERETT, WA 98201 <br />425-257•8810 — FAX 425-257-8857 <br />Sil E ADDRESS PARCEL TAX I.D.1 <br />�.3z 97'� G� � vo �� �- o«� - o ���- o 0 <br />LEOA LOT N0�7. BLOCK TRACT/�� /� <br />DESC.^ / / /GP�L����GY �iY1.f� <br />�7.1-��.v�A/ I .Iiif�.i.i�C' <br />TENA NAME <br />CONTRACTOR <br />PMONE � <br />.( � <br />PROPOSED USE Of BUILDINO <br />cOh RACT PNICE OF WOqK <br />WOHK VERa',FIIPTION <br />S�';2 �%���> ���r% <br />' i N0. I TYPE OF FIXTURE OR REM <br />wnTERCLOSET <br />BATHTUB <br />� LAVATOFY (WASH BASIN) <br />= SHOWER <br />� KITCHEN SINK f. DISPOSAL <br />� DISHWASHER <br />= LAUNDfiV TRAY <br />� CIOTHES WASHER <br />�URINAL <br />DRINNING FOUNTAIN <br />FLOOR ORAIN <br />BACKFLOW PREVENTER <br />_ SINK (SERVICFIBAR/MOP/ETC.) <br />� OTHER <br />i[. l ✓ S7'l'wV <br />COI(TACT NAME <br />���� <br />ADDRESS <br />Bu(Iding � Mechenical <br />PERAIIT Cambination Plumtmg <br />IYPE Demolilion Sign <br />_ Spdnkler <br />PF.RMR I <br />CO�{ O(- <br />aP PHONE <br />y tii s-��y dsz3 <br />PHONE <br />— '7l�=J37-ci,,.� /S <br />LP CONTR. UCEN8E I <br />�EG/9c N�c%y5%�C <br />Adtlition MEAT SOURCE <br />WORK Alte�allon Elxtrk <br />IYPE New � pe� <br />RepeiUMeint. plhar <br />CfTY OF EVERETT LOCAL SALES 7AX COOE 18 �706 <br />� � . �• 3 �; �-� �� l rcc� <br />NO. I TYPE OF FIXTURE OR�REM <br />� <br />� <br />/ <br />� <br />' �vu – A/HANDLING UNITS <br />FORCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT HEATEFS <br />CLOTHES ORYER <br />RANGE HOOD <br />WATER HEATER <br />METAL FIREPLACE/STOVE <br />FIREPLACE INSERT <br />(3AS FIREPLACE <br />OAS RANGE <br />OAS PIPING <br />EXHAUSTFAN <br />OTHER <br />I HEREBY CERITIFY THAT 1 HAVE READ AND EXAMINED THIS APPLICATION AND KNOW TME SAME TO BE THUE AND CORHECi. ALL <br />PFOVISIONS OF LAWS AND ORID�NACES CiOVERNING THIS TYPE OF WONK WILL BE COM�LIED WITH WHERiER SPECIFIEO HEFEIN OR <br />NOT. THE GRANTING OF A pERMl7 DOES N07 PRESUME TO OIVE AUTHOHITV TO VIOUTE OR CANCEL THE PROVISION OF ANV OTHER <br />STATE OR LOCAL LAW REGUTATING CONSTqUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAi I AM AUTHORI2ED BY THE <br />OWNER�IS PROPERTY TO PERFOHM THE WORK FnR WHICH APPLICATION IS MA�E AND I COMPLV WITH THE S.'ATE <br />CONT T RS UV 1B?7 RC AiJ0298.200 WAC. <br />: � y� <br />� , _� ����� � /-�c� r��/ <br />