1918 LOMBARD AVE 2016-01-01 MF Import

� PERMIT APPLiCATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 93201 425-257-8810— FAX 425-257-8857 SITE ADDRESS PARCEL TAX I.D.# PERMIT# % c�.� Oo% 3�9.�8Za2,�o� � /i� -o�� LEGAL LOTNO. BLOCK TRACT DESC. OWNER I ADDRESS PHONE TENANT NAME I CONTACT NAME PHONE CON7RACTOR ADDRESS CONTR. LICENSEM PHONE FROPOSED USE OF BUILDING Building Mechanical Addition HEAT SOURCE `\ PERMIT R Combination R Plumbing WORK R Alteration D Electric / ) ! TYPE Demolition � Sign TYPE D New D Gas •!/P�t'n�s2 B Sprinkler U Repeir/Maint. U Other CONTRACT PRICE OF RK � CI7Y OF EVERE7T LOCAL SALES TAX CODE IS 3705 WORK DESCRIPTION PLUMBING MECHANICAL NO. TYPE OF FIXTURE OR ITEM N0. TYPE OF FIXTURE OR ITEM _ WATERCLOSET _ A/C—A/HANDLINGUNITS _ BATHTUB _ FORCED AIR SYSTEMS _ LAVATORY (WASH BASIN) HEAT PUMP SHOWER _ UNIT HEATERS _ KITCHEN SINK 8 DISPOSAL _ CLOTHES DRYER _ DISHWASHER _ RANGE HOOD _ LAUNDRY TRAY WATER HEATER _ CLOTHES WASHER _ METAL FIREPLACE/STOVE _ URINAL _ FIREPLACE iNSERT _ DRINKING FOUNTAIN _ GAS FIREPLACE FlOOR DRAIN _ GAS RANGE _ �ACKFLOW PREVENTER _ GAS PIPING _ SINK(SEP.VICE/BAR/MOP/ETC.) _ EXHAUST FAN _ OTHER _ OTHER I HEREBY CERITIFY THAT I HAVE READ AND EXAMINED TH�S APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING:7F A PERMIT OOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER STATE OR LOCAL lAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. TFiAT I AM AUTHORIZED BY THE OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE CONTRACTORS LAW 1827 RCW AND'296.200 WAC. Signature of OwnedContractor/Authorized Agent Date