Laserfiche WebLink
/y-')i,S-.7 <br />r:HERMIT APPLICA~*'ON <br />CITY OF EVERE17 PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257.8857 <br />SITE ADDRESS PARCEL TAX I.D. M PERMIT 0 <br />,11 7 '74it� S�-. St= Tic-flraa - <br />LEGA LOT NO. BLOCK TRACT <br />DESC. <br />TENANT NAME <br />CONTACT NAME <br />PHONE <br />CONTRACTOR ADDRESS ZIP CONTR. LICENSE I <br />Pa.+Yio1 1 pr-54 71--. !',v-. 2707 -20-1r" i4— E, <br />PHONE <br />v25'3-9 At.- () Tcaww wA q&4dti PATYZLrPDggcP <br />PROPOSED USE OF BUILDING Building f-1 Mechanical Addition HEAT SOURCE <br />PERMIT Combination II-v--(( Plumbing WORK R Alteration (� Electric <br />TYPE Demolition Sign TYPE [®� New B Gas <br />Sprinkler Repalr/Maint. Other <br />CONTRACT PRICE OF WORK9o, oET <br />D CIrY OF EVERT LOCAL SALES TAX CODE IS 3105 <br />WORK DESCRIPTION <br />al <br />J.l1SkaJ-k. Ft re_. S P vn\c.. <br />PLUMBING <br />NO. TYPE OF FIXTURE OR ITEM <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />WATER CLOSET <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 DISPOSAL <br />DISHWASHER <br />LAUNDRY TRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTER <br />SINK (SERVICE/BAR/MOP/ETC.) <br />OTHER <br />X_ <br />A/C — A/HANDLING UNITS <br />FORCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT HEATERS <br />CLOTHES DRYER <br />RANGE HOOD <br />WATER HEATER <br />METAL FIREPLACE/STOVE <br />FIREPLACE INSERT <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUST FAN <br />OTHER C'1 SPnnilt� <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />I HEREBY CERITIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE 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 LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION, THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />ITRACTORS LAW 18.27 RCW AND 296.200 WAC. <br />Signature o wnar/� ntractar/ uthorize Agent Date <br />�IL <br />