319 76TH 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 SITE ADDRESS 319 7(�� ,(72k�T PARCEL TAX I.D.N PERMIT a N.d LC3 JO :!O.-p D 00 U O!o 00 S CJ r�a LEGAL LOT NO. BLOCH TRACT DESC. OWNER ��.n / OF � �-� ADDRESS �y3 p ►'V/6rAwv A/E PHONE 7 Eve�rr, W TENANT NAME CO , I CONTACT NAME \ PHONE � " / &oto l,G-AA- kiD10 Sys err StAo �1�1 -4 CONTRACTOR1 ADDRESS CONTR. LICENSE I k!r» Akf- Q / I PHONE TME 'ROPOSED USE OF BUILDING Building Mechanical Addition HEAT SOURCE PERMITCombinelion R Plumbing WORK Alteration Elrwaic 9i/ �MMOA/ivL�OAls '.YPE Demolition D Sign TYPE Now Gas Sprinkler Repair/Maint Other CONTRACT PR—ICE OF WORK , I?C7 CITY OF EVERETT LOCAL SALES r AX CODE IS 3105 WORK DESCRIPTION PLUMBIN„ MECHANICAL NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM _ WATER CLOSET __ A/C -A/HANDLING UNITS _ BATHTUB FORCED AIR SYSTEMS _ LAVATORY(WASH BASIN) __ HEAT PUMP _ SHOWER __ UNIT HEATERS _ KITCHEN SINK 8 DISPOSAL _ CLOTHES DRYER _ DISHWASHER RANGE HOOD _ LAUNDRY THAI __ WATER HEATER _ CLOTHES WASHER __ METAL FIREPLACE/STOVE URINAL __ FIREPLACE INSERT DRINKING FOUNTAIN ___ GAS FIREPLACE FLOOR DRAIN -__ GAS RANGE _ BACKFLOW PREVENTER GAS PIPING SINK(SERVICE/BARhAOP/ETC.) __ EXHAUST FAN OTHER - OTHER _— I HER CERITIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF JAWS 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 Tf.E PROVISION OF ANY 01 HER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE CF CONSTRUCTION THAT I AM AUTHORIZED BY THE OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE CONTRACTORS LAW 10.27 RCS N 295.200 W�C. L� � r �� 4 d so ale Signature of Uwnerl--,i t d Uthontod gen '—73 54 3