Laserfiche WebLink
� � <br />I <br />� <br />SI7E ADDRESS <br />f,��2�5.�.�af�Yv� <br />LEG:: l.P"! NQ. <br />D'cSC. <br />OW`!FR '---- <br />I TENANTNAME <br />PHONE <br />R"-:RMIT APPLICATa�,N <br />CITY OF EVEPETT PERG,�IT S�RVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FhX 425-257-8857 ���ag_ od� <br />F r�- <br />q2�'2290 <br />PROPOSED USE OF BLiILDING <br />CONTRACT PRICE OF WORK <br />WORK DESCRIPTION � Q <br />dYesS�n� <br />� <br />PERMIT <br />TYPE <br />� �` <br />�(ooM <br />PLUMBING <br />NO. � TYPE OF FiXTURE OF REM <br />WATER CLOSET <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHUWER <br />KITCHEN SINK 8 GISPOSAL <br />DISHWASHER <br />LAUNDRY 7RAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOC�A DRAIN <br />BACKFLOW PREVENTER <br />SINK (SERVICE/8ARlMOP/ETC.) <br />OTHER <br />PARCEL TAX I.D. # <br />TRACT <br />ICONTACTNAME <br />�Pd �SI <br />�Z N 1 N" �� • ZIP <br />Tac�Q, c,J f� 9 gy: <br />�Building n Mechanical <br />Com6ination �--} Plumbiny <br />Demolilion � Sign <br />Sprinkler <br />C'�'�e -Fi�� Sp(I <br />1(2Y�'IOdE�S � <br />PERMIT k <br />PHONE <br />,v�qyo -7�8 g <br />CONTR. LIC � � $ �C F <br />PRTRI � <br />Addition <br />WORK Alleralion <br />TYPE New <br />Repair/Maint. <br />HEATSOURCE <br />Electric <br />Gas <br />O[her <br />CITY OF C-VERETT LOCAL, SALES TAX CODE IS 3105 <br />N0. I P'PE UF FIXTURE OR ITEM <br />� <br />AIC — A/HANDLING UNITS <br />FORCED AIR SYSTEMS <br />HEAT PUMP <br />UNIT HEATEFS <br />CLOTHES DRYER <br />RANGEHOOD <br />WATER HEATER <br />METAL FIREPLACE/STOVE <br />FIREPLACE INSERT <br />GAS FIREPLACE <br />�AS RANGE <br />GAS PIPING <br />EXHAUSTFAN <br />OTHER _ <br />1 HEREBY CERITIFY THAT I HAVE REAO AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORFt� i. n�� <br />PROVISIOPlS OF �WS AND ORIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />S� TE R LOCAL ILAW REGULATING CONS RUCTION OR TH�E ERFORMAN E OF CO STRUOCT ONN THAT AM AUTHORI ED BY HEHER <br />OWNER OF THIS PROPERTY TO PEf;FORM THE WORK FOR WHICH APPLICATION IS MADE P.ND I COMPLY WITH THE STATE <br />� rtoecT(lRC I AW 1R.77 RCW AND 296200 WAC. <br />