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SITE ADDRESS <br />NO. <br />DESC. <br />�, � — <br />TENANTI�AME <br />J�)v� r�s./� <br />P�RMIT APPLICATIUN <br />CITY OF EVERETT PERMIT SERVI�ES <br />3200 CEDAR STREET, EVER6TT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — w-vw.evereltwa.org <br />APPLICATIONS ARE ACCEPTEU FROM 8 AM TO 4 PM <br />�� <br />CONTR. UCENSE # C� �-� I' U`"'�� <br />USE OF BUILDING <br />� <br />WORK DESCRIPTION <br />�(' �C(ly— <br />N0. I TYPE OF FIX7URE OR ITEM <br />Toilel <br />Balhlub <br />Lavalory (wash basin) <br />Shower <br />Kitchen sink 8 disposat <br />Dishwasher <br />Clolhes washer <br />Water heater <br />Smk (ser:iceiharlinopielc.j <br />Backflow prevenler <br />Urinal <br />Drinkinc� Founlain <br />Floor drain <br />Grease trap <br />Roof drains <br />Othcr <br />PARCEL TAX I.D. # <br />TRACT OR SUBDIVISIOIJ p <br />7 `� �� '� <br />PERMIT# <br />�7'�T'1 -O5� <br />�,<;IU I�cv�11�, I�� E�Kff .�z� <br />CONTACT FOR PERMIT PH�N�2 �y,�� / <br />_ YZS <br />j�� 11 V1 <br />D S <br />HEATSOURCE <br />_ Electric _ Gas _ Other <br />� C� fy UI, PcI G <br />CONTRACT PRICE nF WORK <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C - air handling uuils <br />Forced air syslems <br />Gat� piping <br />Water healer <br />Gas fireplace <br />Gas range <br />Clolhes dryer <br />Range hood <br />Exhaustfan <br />Heal pump <br />Unit heater <br />Boiler <br />� Rofrigeration <br />Woods!ove <br />Olher <br />^_!'Y Of EVERETT LOCAL SALES TAX CODE IS 7105 <br />I hereby ceritify that I have read and examined this application and know lho same lo bo true and correcL All proviswns of laws and <br />ordinaces goveminy this rype of work will be complied with whether speci(ied herein or nol The c�ranling of a permit does nol presume <br />to give aulhonty to violale or c2ncel Ihe provision of any olher slale or local law rec�ulaling construclion or lhe peAormance of <br />conslruclion. Thal I am aulhorized Uyilhe owner of this property lo pedorm lhe work (or which application is made and I comply wilh tho <br />Slale CaNractors Law iR.27 RCWIanA 296.200 WAC. <br />� i � , � � ; �� �� � % l (� �� C� <br />,� <br />� <br />� -----____ <br />