Laserfiche WebLink
r @ RonEPi <br />LRMIT APPLICATN D <br />T� <br />00;L CITY OF EVERETT PERMIT SERVICES JUL 2 9 2002 <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257.8810 — FAX 425-257-8857 CITY OF EVERET', <br />Enphreerinp/PUblIc Services <br />SITE ADDRESS ,Q <br />-A 5310 - 919 L sT , ! UU <br />PARCEL TAX I.D. M <br />,c Oo7a 30 001 �00 <br />RMIT w <br />do'�C?-0 <br />LEGAL LOT NO. <br />BLOCK <br />TRACT <br />DES <br />OWNER ADDRESS ZIP PHONE 35 3- 568;2- <br />v RDL- JA A• SIh1K 6AMF `S.W 425) aa0 - 6 6 UI <br />TENANT NAME CONTACT NAME PHONE <br />K itJ /A <br />CONTRACTOR ADDRESS ZIP CONTR. LICENSE e <br />PHONE <br />PROPOSED USE OF BUILDING <br />I _ <br />/.l�ur 7Aw L-,1 t-} VqE <br />\ <br />PERMIT <br />TYPE <br />Building f-1 Mechanical <br />H Combinalion IIL--J(t Plumbing <br />Demolition Sign <br />Sprinkler <br />WORK <br />TYPE <br />I <br />Addition <br />R Alleml,on <br />New <br />Repair.rM1laint. <br />HEAT SOURCE <br />I� Electric <br />BGasr <br />Other <br />CONTRACT PRICE OF WORK <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />WORK DESCRIPTION RED his?. <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />NO. TYPE OF FIXTURE OR ITEM <br />WATER CLOSET <br />_ <br />A/C — A/HANDLING UNITS <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />Kll HEN SINK 8 DISPOSAL <br />DISHWASHER <br />LAUNDRY TRAY - <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <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 />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />FLOOR DRAIN <br />BACKFLOW PREVENTER <br />SINK (SERVICFJBAR MOP/ETC.) <br />OTHER <br />_ <br />GAS RANGE <br />GAS PIPING <br />EXHAUST FAN <br />OTHER_ <br />_ <br />_ <br />I HEREBY CERITIFY THAT I HAVE READ r`NO EXAMINED THIS APPLICATION AND KNOW THE SAME T l DE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORIDINACES �iOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES I IOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br />STATE OR LOCAL LAW REGULATING CONST SUCTION 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 />CONTRACTORS LAW 18.27 RCW AND 296.200 VAC. <br />� * 6 hat 7-IG-os� <br />Signature of Owner/Con acior/Aumonzed Agent Date <br />