110 76TH ST SW 2016-01-01 MF Import

PLRMIT APPLICATIL N O:rr CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, V"4 98201 425-257-8810 - FAX 425-257-b 7 SITE ADDRESS, i PARCEL TAX I.D.N PERMIT x LEGA LOT NO. BLOCK TRACT DESC. OWNER ADDRESS ZIP PHONE C ec-wo L Hqfuli; //O -76" 4 �- :! iW W263 TENANT NAME CONTACT NAME PHONE C l�eCilOq `L HARRIS /ZLx �42rZr t 4z>- 34-7 -7404 I 425 "74 L -3S3ov CONTRACTORr--rr�� ADDRESS ZIP CONTR. LICENSE M PHONE D to C- �- PROPOSED USE OF BUILDING Building Mechanical Addition I HEAT SOURCE PERMIT 1R-( Combination Plumbing WORK IR-( Alteration R Electric �7�StCJ�faT/r{ L I TYPE �,J Demolition Slgn TYPE L_f New �.-/ Gas L� Sprinkler LJ Repa,riMaint. LJ Olher CONTRACT PRICE OF WORK / / CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 ^ WORK DESCRIPTION I�pl l.((� Jyot-✓C_-yZ -M EXISTf A-(G Y/2 e'4rN. ^A t2r2tr-/6 S/MK Fv/2 W'7-e NCM . PLUMBING MECHANICAL NO. TYPE OF FIXTURE 09 ITEM NO. TYPE OF FIXTURE OR ITEM _ WATER CLOSET _ A/C -AIHANDLING UNITS _ BATHTUB _ FORCED AIR SYSTEMS LAVATORY (WASH BASIN) _ HEAT PUMP SHOWER _ UNIT HEATERS _ KITCHEN SINK 8 DISPOSAL _ CLOTHES DRYER _ DISHWASHER RANGE HOOD _ LAUNDRY TRAY WATER 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.) EXHAUST FAN OTHER OTHER I HER-BY CERTIFY THAT I HAVE READ AND EXAMINE)THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROV SIGNS OF LAWS AND ORIDINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT THE GRANTIN 3 OF A PERMIT DOES NOT PRESUME TO GIVE AUTHOHITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER STATE OR LOCA!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 WITH THE STATE CONT I1AC ORS LAW 18.27 R/CW AND 296,200�WAC. Signal ire of OwneuConlractouAuthonzed Agent Date