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SITE ADDRESS <br />U�T NO. <br />P�RMIT APPLICAI'ION <br />CITY OF EVERETT PERMIT SERVICE.� <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 />BI_OCK <br />PARCEL TAX I.D. # <br />TRACT OR SUBDIVISION p <br />PERMIT A <br />I �U$ - OO� <br />TENANT NAME I CONTACT FOR PERMIT PHONE �O �I Z"� S�j <br />�ah�dli� �'�J�- <br />NTRAf TO <br />ca� ��.�d��j <br />CONTR. LICENSE z <br />Gl l <br />USE QF BUILDING <br />�v� <br />wtr_�e+Ki7'�� wa. <br />s(x�, �L28, �(��(� <br />— HEAT SOURCE I CONTRACT PRICE OF WORK <br />Electric _ Gas _ Other ��� Z� - v J <br />WORK DESCRIPTION /J (�' �r .�. <br />�C?Lt�4'�T �N,�I�v,•,� �t� -T `t-oJ 6-F+d�� S� •—C- <br />PLUMBING <br />NO. � TYPE OF FIXTURE OR ITEM <br />Toilet <br />6athtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/mop/elc.) <br />BackOow prevenler <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease lrap <br />Roof drains <br />Olher <br />NO. I TYPE OF FI%TURE OR ITEM <br />AIC - air handling units <br />Forced air systems <br />Gas piping <br />Watar heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaust tan <br />Heat pump <br />Unit healer <br />Boiler <br />Refrigeration <br />Woodslove <br />Other <br />CITY OF EVERETT LOCAL SALES SAX CODE IS J105 <br />I hereby certi(y that I have read and examined this application and know lhe same to be lrue and correct. All provisions of laws and <br />ordinances governing this type of work will be complied with whether specifed herein or noL The granting of a permil does not presume <br />to give authoriry to violale or cancel the provision of any other state or local law regulating construction or the performance of <br />conslruction. That 1 am authorized by lhe owner of lhis property lo perform lhe work for which application is made and I comply with the <br />Stale Contraclors Law,18.27 RCW and 296.200 WAC. <br />,l� � ---� �--� �izY�o�o <br />