3711 SMITH AVE 2016-01-01 MF Import

P.,RMIT APPLICATI� N CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 425-257-8810— FAX 425-257-8857 SITE ADDRESS PARCEL TAX I.D.N p (3�7 f I S,� � ��1 V-e ,�j�/�/�D GY�� LEGA LOTNO. BLOCK TRACT DESC. OWNER AODRESS ZIP PHONE �VQve �I �aSPa� ��SS � �"` k25- z5z- 4776 TENANT NAME CONTACT NAME PHONE Lo�v�� — I�c�, �- �Z ��ZS �O8 �5 G4 ca.eQ CONTRACTOR AODRESS LP CONTR.UCENSE• PHONE PROPOSED USE OF BUILDING ��Uild'If7J � Mechanical ��n A��'ddllion MEAT SOURCE PERMIT � ) GPmbination Plumbing IWORK �ItPration I �lectric TYPE ❑Demolition Sign TYPE New Gas �'�S nnklef Re aiNMaint. Olher CONTRACT PRICE OF WORK �^^^ — CITY OF EVERETT LOCAL SALES TA%COOE IS�705 ( /l KJ WORK DESCRIPTION .1 ��V i�J�2 uh��n C�I e�l r V of� ��t�J ��J D V'oOwt S PLUMBING MECHANICAL NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FlXTURE OR ITEM WATER CLOSET A/C–A/HANDIING UNITS BATHTUB _ FORCED AIR SYSTEMS LAVATOFY(WASH BASIN) HEAT PUMP SHOWER UNIT HEATERS KITCHEN SINK d DISPOSAL _ CIOTHES DRYER DISHWASHER RANGE HOOD LAUNORY'iflAY WATER HEATER CLOTHES WASHER METAL FIREPLACE/STOVE I _ URINAL _ FIREPLACE INSERT DRINKING FOUNTAIN . _ GAS FIREPLACE I FLOOR DRAIN _ GAS RANGE I _ BACKFLOW PFEVENTER _ GAS PIPING � _ SINK (SERVICE/BAR/MOP/ETC.) _ EXHAUST FA�J OTHER OTHER � — � II HEFEBV CERITIFY 7HA71 HAVE READ AND EXAMINED THIS 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 5.^ECIFIED HEREIN OR , NOT. THE GRANTING OF A PERMIT DOES NOT PFESUME TO GIVE AUTHORIN TO VIOUTE OA CANCEL THE PROVISION OF ANY OTHER STATE Ofl LOCdL LAW REGULATING CONSTRUCTION OR THE PEFFORIdANCE OF�ONSTRUCiIUN. TNAT I AM AUTHORIZED BY THE OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE ANO i COMPLY WITH THE STATE � CONTRACTORS LA1N 192�W AND 296.200 WAC. I � / - (, ' 'j — OZ Signalure o�Ow r/ nlractor ulhorized Agenl Date i I /_/