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Dec. 6. 2013 12:15PM <br />No.0988 P. 3 <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 90201 <br />425.257.8810 - FAX 425-257.8857 - www.everettwa.org <br />APPLICATIONS ARE ACCEPTHD FROM 8 AM TO 4 PM aL -06 —13 <br />SITE ADD S �,/j,� PARCEL TAX I.D. a A IT M�) Z �O <br />LEGAL LOT NO. BLOCK TRACT OR SUBDIVISION <br />DESC. CITy21p PN <br />O ER ADDRESS <br />�72, 123 <br />►o^ S� ACT ttlER z5 [ <br />L�e A <br />TENANT NAME I CONTACT FOR PERMIT PRONE 4'L=J z ✓' <br />ISDRL'^u5 eve lreq CCU, <br />, <br />Irlc- 1415 �r I� U!IZ�25 <br />USE OF BUILDING <br />HEAT SOURCE <br />—Electric _/Gas, Other <br />WORK DESCRIPTION <br />-" — P_LQU-MBING [ I� <br />No. I TYPL OF FIXTURE On ITEM <br />©athlub <br />_ Lavatory (wash basin) <br />Shower <br />_ Kitchen sink 6 disposal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink eervice/bar/mop/etc.) <br />Sockllowpreventer <br />_ Urinal <br />Drinking Fountain <br />Floor drain <br />Grease bap <br />Hool drains <br />Other <br />NO. <br />CONTRACT PRICF OF WORK <br />TYPE OF FIXTURE on ITEM <br />NC - air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unll healer <br />_ Boller <br />Refrigeration <br />Woodsloy a'�? <br />Other r. . IrVI.�,C t., <br />CITY OF EVERETT LOCAL GALES TAX CODE IS 3105 <br />I hereby earthly that I have road and examined this application and know the same to be true and correct Allprovisions of laws and <br />10 g ve authority 10 governing <br />this or cancel worke of will <br />IN uvislon of any withwhether <br />sla ar orlocallawfied erein of regulatingiThe const granting <br />o 1 he Per of a rt does not rmanca of presume <br />construction. Thal I am authorised by the 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 296 200 WAC <br />iS p aru of Owner/Co actor/ uth Agent Date <br />