11810 24TH DR SE 2016-01-01 MF Import

� PE�. �MIT APPLICATIO�. � CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 9&201 425-257-8810 - FAX 425-257-8857 SITE AD!1RESS PARCEL TAX I.D.M PERMIT x LEGA LOT NO. BLOCK TRACT DESC. OWNER ADDRESS ZIP PHONE TENANTNAME I CONTACTNAME PHONE ,I CONTRACTOR _ ADORESS ZIP CONTR.LICENSE M � PHONE PROF`OSED USE OF BUILOING Building D MeChaniCal Atldilion HEA7 SOURCE PERMIT R Combination U Plumbing WORK R Alteralion R Electri;. TYPE D Demolition �, Sign TYPE � New �] Gas U Sprinkler RepaidMaim. U Other CONTRACT PRICE OF WORK CITY OF EVERETT LOCAL SALES TAX COUE IS 3105 WORK DESCRIPTION PLUMBING MECHANICAL NO. TYPE OF FI%TURE OR ITEM NO. TYPE OF FIXTURE OR REM _ WATER CLOSET _ A/C—A/HANDLING UNITS _ BATHTUB _ FORCED F.IR SYSTEMS _ LAVATORY(WASH BASIN) _ HEAT PUMP _ SHOWER _ UNITHEATERS __ KITCHEN SINK& 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 _ BACKFLOW PREVENTER _ GAS PIPING _ SINK(SERVICE/BAWMOP/�'':.) _ EXHAUST FAN _ OTHER_ _ _ OTHER I — � I HEREBY CERI1"IFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL � PROVISIGNS OF LAWS AND ORIDINACES 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 . STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE i OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE • CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. i Signature ol Owner/CoNractodAuthonzed Agent Date