3332 COLBY AVE 2016-01-01 MF Import

F��RMIT APPLICATI'� N CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 425-257-8810—FAX 425-257-8857 SITE ADDFiESS PARCEL TAX I.D.N PERMiT H 333� C�, l 1„ i3oao�,-flsa LEGA LOT NO. BLOCK TRACT DESC. OWNER ADDRESS ZIP PHONE � r. - -� ��t u r� � 3 3.2 C� , — �„ o -� 1 f:2o TENANT NAME I �NTACT NAME PHONE UW �^-� � � h �a�.Q � � �,.� 41S-95s3 � 7 �; x CONTRACTOR ADDRESS ZIP CONTR.LICENSE M PHONE Uw ti�e r • PROPOSEO USE OF BUILDING BUildirtg Mechanical Addilion HEAT SOURCE PERMIT R Com6inalion � Plumbing WORK R Alteralion n Electric TYPE D Demolilion Sfgn TVPE D New D Gas U Sprinkler U Repair/Meint. D Other CONiRACT PRICE OF WORK CITV OF EVERETT LOCAL SALES TAx CODE IS 3105 WOAK DESCRIPTON :��-�� i� a - 3s' i� � ...� ro � 7. P PLUMBING MECHANICAL NO. TYPE OF FlXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM _ WATERCLOSET _ A/C—AMANDLINGUNITS ._ BATHTUB _ FORCED AIR SYSTEMS _ LAVATORY(WASH BASIN) _ HEAT PUMP _ SHOWER _ UNIT HEATERS _ KITCHEN SINK&DISPOSAL _ CLOTHES DRYER _ DISHWASHER _ RANGE HOOD _ IAUNDRY TRAY _ WATER HEATER � _ CLOTHES WASHER _ METAL FIREPLACE/STOVE � _ URINAL _ FIREPIACE INSERT , _ DRINKING FOUNTAIN _ GAS FIREPLACE _ FLOOR DRAIN _ GAS RANGE _ BACKFLOW PREVENTER _ GAS PIPING _ SINK(SERVICE/BAF/MOPlETC.) _ EXHAUST FAN _ OTHER _ OTHER I HEREBV CERITIFY THAT I HAVE READ AND EXAMINED THIS APPIICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF IAWS AND ORIDINACES GOVERNING THIS iYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OFi . NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOl.4TE OR CANCEL THE PROVISION OF ANY OTHER STATE OR LOCAL LAW REGULATINCa CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT i AM AUTHORIZED BY THE �, OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE ' CONT CTOR W iB.27 RCW AND 296.200 WAC. I � ...�' � ,�-a _._. ��/�/�z � Signalure wner/CoNractodAulho zed Agent Date ^` � `�i