8 59TH PL SW 2016-01-01 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.A RMIT 0 `6 .5q ", I- sw I vo 61 (' 4 000040od -D Ldi LEGAiL LOT NO. BLOCK TRACT OR SUBDMSION• DEsc 40 000 D-00 No 3 OWNER ADDRESS CITYIZIP PHONE Ra,vldStidt14kA . G g - 'FL 'C'4 CJ eve 4-} 1�4Zo3 TENANT NAME 1V--j CONTACT FOR PERMIT PHONE 200 '790 •ITO- 12 �r✓l( S A IDec-v-*°/ DA41eVa VPJ E-MAILdeCV- i CUNIKAUIUK � t J �EIfo sL,Y- VXACJ�Lu)KCONTR.LICENSF 0 DGCKP * q"` BP SrK I qspo 7- USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK S ( � evict _Electric _Gas_Other I d m08 WORK DESCRIPTION PLUMBING J MECHANICAL NO. TYPE OF FIXTURE OR ITE NO. TYPE OF FIXTURE OR I Toilet AIC—air handling units Bathtub / Forced air systems _ Lavatory(wash basin) L I /1 Gas piping Shower Water heater Kitchen sink 8 disposal Gas fireplace Dishwasher Gas range Clothes washer Clothes dryer _ Water heatrr Range hood _ Sink(servicelbarlmopletc.) Exhaust fan _ Backflow preventer Heat pump _ Urinal Unit heater Drinking Fountain _ Boiler Floor drain _ Refrigeration Grease trap WoMstove gq0000f drains her_ Other CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 1 hereby certify that I have read and examined this application and know the some to be true and correct. All provisions of laws and ordinances 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 owner of this property to perform the work for which application is made and I comply wth the St ontract Law_18,27 RCW and 296.200 WAC. gna ure Of er/ onlractorl onzed Agent Date