1919 HOLLOW DALE PL 2018-01-02 MF Import

PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 425-257-8810 — FAX 425-257-8857 — www.everettwa.org APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM SITE ADDRESS PARCEL TAX I.D. p PERMIT p / LEGAL LOT NO. BLOCK TRACT OR SUBDIVISION it DESC. OWNER ADDRESS CITYIZIP PHONE TENANT NAME CONTACT FOR PERMIT PHONE E-MAIL CONTRACTOR^� —ADDRESS CITY/ZIP ZIP PHONE: CONTR. LICENSE p USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK — Electric _ Gas Other I — WORK DESCRIPTION nn PLUMBING MECHANICAL NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM Toilet _ A'C — air handling units _ Bathtub _ Forced air systems _ Lavatory (wash basin) _ Gas piping _ Shower _ Water heater _ Kitchen sink 8 disposal _ Gas fireplace Dishwasher Gas range _ Clothes washer Clothes dryer _ Water heater _ Range hood _ Sink (service/bar/mop/etc.) Exhaust fan _ Backflow preventer Heat pump Urinal Unit heater _ Drinking Fountain Boiler _ Floor drain Refrigeration _ Grease trap Woodstove drains Other =Roof Other =I CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 1 hereby ceritify that 1 have read and examined this application and know the same to be true and correct. All provisions of laws and ordinates governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provision of any other slate or local law regulating 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 Contractors Law 18.27 RfC-W and 296.200 WAC. 7 Signature of Owner/Contractor/Authorized A Date