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PERMIT <br />SITE ADDRESS <br />si-- <br />PARCEL TAX I.D. If <br />PERMIT # <br />1313 -13 1#3'-d <br />0b,�17a vL,l no zoo <br />,-. <br />LEGAII LOT NO. <br />BLOCK <br />TRACT <br />DESC. <br />OWNER ADDRESS CITY/Zip PHONE <br />Skmf � <br />�,;( wc_eQ 1313-8 La 3 =`� �rP.t>z,� y o�S" - 7/0 •- a� a �/ <br />TENANT NAME <br />CONTACT FOR PERMIT PHONE <br />CONTRACTOR ADDRESS CITY/ZIP PHONE <br />CONTR. LICENSE p 6 G �,6 5 F/ / <br />USE OF BUILDING <br />HEAT SOURCE <br />CONTRACT PRICE OF WORK <br />, i ),' <br />_Electric � Gas —Other <br />I <br />,Jvuri "Ov <br />WORK DESCRIPTION <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />NO. TYPE OF FIXTURE OR ITEM <br />T iilel <br />A/C — air handling units <br />_ <br />Bathtub <br />� <br />Forced air systems <br />_ <br />_ <br />Lavatory (wash basin) <br />_Gas <br />piping <br />Shower <br />Water heater <br />_ <br />Kitchen sink 8 disposal <br />Gas fireplace <br />Dishwasher <br />_Gas <br />range <br />_ <br />Clothes washer <br />Clothes dryer <br />_ <br />_ <br />Laundry tray <br />Range hood <br />Sink (servlca/bar/mop/etc.) <br />Exhaust fan <br />_ <br />_ <br />BackOow preventer <br />_Heat <br />pump <br />Urinal <br />Unit heater <br />_ <br />_ <br />Drinking Fountain <br />_Boller <br />Floor drain <br />Refrigeration <br />_ <br />_ <br />Grease trap <br />Woodstove <br />_ <br />hoof drains <br />_Other <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 7105 <br />I hereby ceritify that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br />ordineces governing this type of work will be complied with whether specified herein or not. The granting of a portrait dons not presume <br />to give authority to violate or cancel the provision of any other state or local law regulating construction or the performance of <br />construction. That I am authorized by. owner of this property to perform the work for which application is made and I comply with the <br />State Contractors LaW 18.27 RCW and 2 8.200 WAC. <br />Signature of caner/ nlractdrl ut o gent Date <br />APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 96201 <br />425-257-8810 —FAX 425-257-8857 — www.evereltwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />