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SITE ADDRESS <br />LOT NO. <br />DESC. <br />i <br />• <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PARCEL TAX I.D. # <br />BLOCK � TRACT OR SUBDIVISION # <br />PERMIT # <br />� <br />`'�C�-� <br />TENANT NAME I CONTACT FOR PERMIT PHONE (�rp• i.{ �•7 <br />Co� <br />CYown �1� �'Yc��-t� ���� �3ox 1Z�13 �...,�.. �• �,��51�7��9 <br />CO TR.LICENSE# �M��` /� �•��\C I-. A Q O-l�g� <br />C. C�w N�r���-1 L.L. ,- •, v r�t , i�v.�•� -� o� <br />USE OF BUiLDING HEAT SOURCE CONTRACT PRICE OF WORK <br />_ Electric _ Gas _ Other � 1 1�, w <br />! <br />WORK DESCRIPTION <br />�. CZ� 5�Y t n�1es' 1���.-s <br />'F�e�bc.a� �2> � �k_1-e_r �-e�S <br />NO. <br />PLUMBING <br />TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clathes washer <br />Water heater <br />Sink (service/bar/mop/etc.) <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C — 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 />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <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 />ordinaces governing this type of work will be complied with whether specified herein or not. The granting df a permit does not pr�sume <br />to give authority to violate or cancel the provision of any other state or local law regulating constnaction or the performance of <br />construction. That I am authorized by the owner of this property to perform the work for which applicatiorr is made and I comply with the <br />