421 61ST ST SE 2016-01-01 MF Import

P�RMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201, 425-257.8810 SITE ADDRESS <- PARCEL TAX I.D.M PERMIT a LEGAL LOT NO. BLOCK TRACT DESC. — OWNER ADD',ESS PHONE 6- AS-3-4d 03 TENANT NAME CONTACT NAME PHONE i CONTRACTOR y';6e ve ADDRESS ICONTR. LICENSE M `/� )..C-7�F.oLEsOOy.,Pi9 PHONE L/,5. 77151` 93/f vev'V'4s•wfl A/v 9Fo9G PROPOSED USE OF BUILDING Building echanical Addition HEAT SOURCE PERMIT Combination Plumbing WORK Alteration D Electric TYPE Demolition Sign TYPE New as UUU Sprinkler RepaiuMaint M Other CONTRACT PRICE OF WORK �' ��(1 CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 WORK DESCRIPTION ,FIECiiT�c- �'�� /��+ � GAr PLUMB_ ING MECHANICAL NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM _ WATER CLOSET A/C-A/HANDLING UNITS _ BATHTUB ! FORCED Ala SYSTEMS _ LAVATORY (WASH BASIN) — HEAT PUMP _ SHOWER _ _ UNIT HEATERS _ KITCHEN SINK 8 DISPOSAL __ CLOTHES DRYER _ DISHWASHER ___ RANGE HOOD _ LAUNDRY TRAY _L WATER HEATER _ CLOTHES WASHER __ METAL FIREPLACE/STOVE URINAL FIREPLACE INSERT DRINKING FOUNTAIN GAS FIREPLACE FLOOR DRAIN __ GAS RANGE _ BACKFI.OW PREVENTER GAS PIPING _ SINK (SERVICEIBAR/MOP/ETC.) EXHAUST FAN OTHER _ OTHER. _ I HEREBY CERITI-Y THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE,SAME TO BE TRUE AND CORRECT ALL PROVISIONS OF LAWS AND CRIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMF LIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOTS NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER STATE OR LOCAL LAW REGULATING CG. 3TRUC1-ION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE OWNER OF THIS PROPERTY^�T ,PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE CONTRACTOR /f AND 296 200 WAC Signature of O'Nner/Contractor/Authorized Agent Date