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4918 BLACK FOREST LN 2016-01-01 MF Import
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4918 BLACK FOREST LN 2016-01-01 MF Import
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Last modified
1/30/2017 7:19:06 AM
Creation date
1/30/2017 7:18:50 AM
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Address Document
Street Name
BLACK FOREST LN
Street Number
4918
Imported From Microfiche
Yes
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JUL-11-2�06 09:33 FROM:PERMIT 4257756335 T0: 14252578857 F.3 <br /> PERMIT AP LICATION <br /> CITY OF EVERETT P RMIT SERVICES <br /> 3200 CEDAR STREET, E ERETT, WA 98201 <br /> 425-257-8810 — F 425-257-8857 <br /> 7 -ll �b� <br /> SITE AD�RESS ���p � !��rY�t PA�E Q s # ��O G e 1�MI�� - �� <br /> ! T`. o M <br /> LEGA LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER ADORESS ZIP PHONE <br /> �l t-(�e�f-e� �-F�ql�el���are ��n:e- zo 3 5�� Z�`/' 9/0 <br /> TENANTNAME CONTACTFORP RMIT PNQNE <br /> �(.-<�?d� yzs �75- 8ti57 <br /> CONTRACTOR � � ADORESS ZIP CONTR.LICENSE# <br /> W HS�.I ��u�t1 �j'2.�I+?C�l.y� A � �! <br /> PHONE G/V�[! �/[OYYI kQ' /�j{ i N JG �'�f�Jf-li�=�'y`�i qg <br /> 1i��0 �L 7GU �iL �Cs��� ( <br /> PROPOSED USE OF BUILDING 8uilding echanlCal Addition HEAT SOURCE <br /> PERMIT R Combination Plumbing WORK �Alteration � Elecvic <br /> �(� ��'J TYPE f� Demolition Sign TYPE New Gas <br /> V �/C� U Sprinkler Repair/MainL Other <br /> CONiRAC7 PRICE OF WORK �G r�/r/1. �— CITY OF EVERETT LOCAL SALES TA7(CODE IS 3505 <br /> � � -r <br /> WORK DESCRIPTION <br /> �lr� ffZll rnS � a.�f f-C��r�� �"�/J 3- f� <br /> PLUMBING McCHANICAL I <br /> NO. TVPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> WATER CLOSET(TOILET) A/C—A/HANDLING UNITS <br /> BATHTUB FORCED AIR SYSTEMS <br /> _ LAVATORY(WASH BASIN) � HEAT PUMP <br /> SHOWER UNIT HEATERS <br /> KITCHEN SINK 8 DISPOSAL CLOTHES DRYER <br /> DISHWASHER RANGE HOOD <br /> LAUNDRY TRAY WATER HEATER <br /> CLOTHES WASHER METAL FIREPLACE/STOVE <br /> URINAL FIREPLACE INSERT <br /> DRINKING FOUNTAIN GAS FIREPLACE <br /> FLOOR DRAIN GAS RANGE <br /> BACKFLOW PREVENTER . GAS PIPING <br /> SINK(SERVICEIBAR/MOP/ETC.) EXHAUST FAN <br /> OTHER OTHER <br /> I HERE6Y CERITIFY THAT I HAVE ftEAD AND EXAMINED THIS APPLICATIO AND KNOW THE SAME TO BE 7RUE AND CORRECT. ALL <br /> PROVISIONS OF LAWS ANO ORIDINACES GOVERNING THIS TYPE OF WO K WILL DE COMPLIED WI7H WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTH RITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br /> 9 fAiE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFOR NCE OF CONSTRVCTION. THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPII ATION IS MADE AND I COMPLY WITH THE STATE <br /> CONT CTORS L4 .27 RCW AND 296.20 <br /> r�a �c� �[1 �4 � <br /> Si at re o OwnedContractor/A rized Agent Date <br /> DEBIT 8 CREDIT CARDS RE NOT ACCEPTED <br />
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