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12704 19TH AVE SE 2016-01-01 MF Import
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12704 19TH AVE SE 2016-01-01 MF Import
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Last modified
4/2/2017 2:08:54 PM
Creation date
4/2/2017 2:08:52 PM
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Address Document
Street Name
19TH AVE SE
Street Number
12704
Imported From Microfiche
Yes
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` rER��IIT APPLICAI �ON <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810— FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM ,Z — �(� — /d <br /> SITE ADDRESS PARCEL TAX I.D.# PEKMIT# <br /> C(iL' /�cv-� �e � _L�3 <br /> 2�0 �� 1�1 <br /> LEGAL LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRESS CITY2IP PHONE <br /> I2�c:�1 CSc.��t.�� tv<-.r_c� Hvy "]-6(0� � tS" 1�1SV <br /> 11.c k�. l 't r L'1 r . ', - u<<r rr R£;i.0 u — <br /> TENANTNAME CONTACTFORPERMIT PHONE <br /> CONTRACTOR �����,,,�.� ����,.�,�,� ADDRESS CITY2IP PHONE <br /> �to L S W W��. :��,cd C.�c pi 3e+o ' S(.. �'PI Cr�Z <br /> CONTR.LICENSE# <br /> 1�al wi � h-+� (-�c�P D S�,o:,��... ,ti 5 ��z�ici <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> `-� r2 I _Eleclric 71 Gas_Other `� Z���q_ �� <br /> WORK DESCRIPTION <br /> (Z._.,� �, v, �j�. s lno�� W�-��-! 1'��e:-4-G�( <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR I7EM <br /> Toilel AIC-air handling units <br /> Balhtub Forced air syslems <br /> Lavatory(wash basin) Gas piping <br /> Shower � Water heater <br /> Kilchen sink 8 disposal _ Gas fireplace <br /> Dishwasher Gas range <br /> Cblhes washer Clolhes dryer <br /> Water healer Range hood <br /> Sink(service/bar/mop/etc.) _ Exhausl(an <br /> Back(low prevenler _ Heat pump <br /> Urinal U�it heater <br /> Drinkinc� Fountain _ Boiler <br /> Floor drain Re(rigeration <br /> Grease Vap _ Woodstove <br /> Roof drains Olher <br /> Olher <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby cerilify lhal I have read and examined this application and know lhe same lo be true and correcl All provisions of laws and <br /> ordinaces�overning this type of work will be complied with whelher specified herein or nol The granting of a permil does not presume <br /> lo give aulhority lo violatc or cancel the provision of any other state or local law regulating construction or lhe pedormance of <br /> construclion.That I am authorized by lhe owner o(this property lo perform lhe work(or which applicalion is made and I comply wilh the <br /> State Contraclors Law 1827 RCW and 296.200 WAC. <br /> ,i �� " � •Z• LS � io <br /> Signalure o(OwnedContracl r/Authorized Agent Date <br />
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