11812 25TH AVE SE 2016-01-01 MF Import

PE� �MIT APPLICATIOi . - CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 425-257-8810 - FAX 425-257-8857 SITE ADDRESS PARCEL TAX '.D.N PERMI7 x LEGA LOT N0. BLOCK TRACT — DESC. OWNER ADDRESS ZIP PHONE TENANTNAME I CONTACTNAME PHONE CONTRACTOR ADDRESS ZIP CONTR.UCENSE N PHONE PflOPOSED USE OF BUILOING BUilding D MBChaniCel Addition HEAT SOURCE PERMIT R Combination U Plumbing WORK � Alleralicn Electric TYPE D Demolition U Sign 7YPE New � Gas D Spfinkler Repair/Maint. Olher I CONTRACT PRICE OF WORK CITY OF EVERETT LOCAL SALES TAX COOE IS 3105 WORK DESCRIPTION PLUMBING MECHANICAL NO. TYPE OF FIXTURE OR REM N0. TYPE OF FI7(TURE OR REM _ WATER CLOSE"i _ A/C—A/HANDLING UNITS _ BATHTUB _ FORCED AIR SYSTEMS _ LAVATORY (WASH BASIi•I) _ HEAT PUMP _ SHOWER _ UNIT HEATERS _ KITCHEN SINK 8 DISPOSAL _ CLOTHES DRYER _ DISHWASHER _ RANGE HOOD _ LAUNDRY TRAY _ WATEF HEATER _ CLOTHES WASHER _ METAL FIREPLACE/STOVE _ URINAL _ FIREPLACE INSERT _ DRINKING FOUNTAIN ,_ GAS FIREPLACE ._ FLOOR DRAIN _ GAS RANGE BACKFLOW PREVENTER _ GAS PIPING _ SINK(SERVICE/BAR/MOP/ETC.) I _ EXHAUST FAN I _ OTHER _ OTHER I • I HEHEBY CEFITIFY'HAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF IAWS AND ORIDINACES CaOVERNING 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 V�OLATE OR CANCEL THE PROVISION OF ANY OTHER STATE OR LOCAL LAW qEGUTATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE iOWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND 1 COMPLY WITH THE STATE CONTRACTORS LAW 78.27 flCW AND 2g6200 WAC. I Signalure ol Owner/ContraclodAulhorized Agenl ate