Laserfiche WebLink
V:RMIT APPLICATI N <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257.8857 <br />SITE ADDRESS IPARCEL TAX I.C. N <br />PERMIT r <br />133Q -),A S-1 s E <br />meow fx* <br />LEGA LOT NO. <br />BLOCK <br />_ <br />TRACT <br />DESC. <br />OWNER ADDRESS ZIP PHONE <br />-)Lt D` <br />Tay C,—j ��,-, I 30 S r 2os� 4zs�-2-g0—S6 <br />TENANT NAME <br />CONTACT NAME PIIONE <br />�w.S (Z.y 'L�.1P—(aF0-`!4by <br />CONTRACTOR ADDRESS ZIP CONTR. LICENSE M <br />&/jSTW,'1j vY,t(�u :cs,l =-�L. IIf 4b 1TL1A"eA)t IQ b^o.0 9J-0r4 eg57N1_,-10-44t9 <br />PHONE <br />aJ1a-1Cfir o-Ob <br />PROPOSED USE OF BUILDING <br />Building ..l echanlcal <br />Addition <br />HEAT SOURCE <br />r,2 <br />PERMIT <br />TYPE <br />B Combination ILHJ( PIul,lbiIT <br />fC7 Demolition Sign <br />WORK <br />TYPE <br />Alterellon <br />New <br />I� Electric <br />Gee <br />S <br />I Sprinkler <br />Rapair/Meint. <br />B Other <br />CONTRACT PRICE OF WORK <br />OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />O <br />WORK DESCRIPTION <br />qAA^y /} 2To� ig:2c.o"D,';.'a,e� t><IsT• I�.ri"-Ice-Sys,'C6n <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />NO. TYPE OF FIXTURE OR ITEM <br />WATER CLOSET <br />A/C — A/HANDLINGUNITS TOr <br />= <br />BATHTUB <br />FORCED AIR SYSTEMS <br />_ <br />LAVATORY (WASH BASIN) <br />HEAT PUMP <br />_ <br />SHOWER <br />UNIT HEA i ERS <br />_ <br />KITGHEN SINK 8 DISPOSAL <br />CLOTHES DRYER <br />_ <br />DISHWASHER <br />RANGE HOOD <br />_ <br />LAUNDRY TRAY <br />WATER HEATER <br />_ <br />CLOTHES WASHER <br />METAL FIREPLACE/STOVE <br />_ <br />URINAL <br />FIREPLACE INSERT <br />_ <br />DRINKING FOUNTAIN <br />GAS FIREPLACE <br />_ <br />FLOOR DRAIN <br />GAS RANGE <br />_ <br />BACKFLOW PREVENTER <br />GAS PIPING <br />_ <br />SINK (SERVICE/BAR/MOP/ETC.) <br />_ <br />EXHAUST FAN <br />i <br />I <br />OTHER <br />— <br />OTHER __ <br />I HEREBY CERITIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TUIUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br />STATE OR LOCAL lV R U G CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF TH C R O ERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACT S' W S AND 296.200 WAC. <br />1- g-0Z <br />Sign ure I wn /Contractor/Authorized Agent Date <br />