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PERMlT APPLICAiIOI� <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 ' i FAX 425-257-8857 www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARJS ARE NOT ACCEPTED <br />I SITE ADORESS <br />l402 5.E <br />LEGAL LOT N0. <br />DESC Q <br />s�C�n u F�S <br />TENANTNAME <br />gR��< oF <br />E V� �� 1T �N AY <br />B�C� <br />iRACT <br />PARCEI. TAX I.D. # PERMIT # <br />2Q05 I$ bU 4G1 �GO Qc�5o3�0 <br />H�vrtcJJ U I T/LIY <br />�G�P/����� 2G411 S.W• gIKCt�yj. NE <br />A M � {e� L/1 <br />CONTRACTOR S � V (�' A� � <br />CONTACT FOR PERMIT <br />.J� rlic� K-o ��I �U�Z <br />Qt cA �2Gdp-��� <br />PHONE <br />�a5.463 i��g <br />AD�RESS � n n S I,�iO�Fy AV� 1�.� PHONE <br />� "i <br />CONTR.LICENSEd S' hY1E dGl,� f0� NT S'-f�, .��0, p�l'QV� I.,,t q f'0D5 <br />YV !� vV I D ✓V/I � D <br />USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br />BRNK D��V�ITf{R�u. /� <br />_ Electric _ Gas _ Other u� d-�. -� <br />WORK DESCRIPTION <br />/T- <br />DRv�al,�al� .cx�sh�c� 2 Ia+�.e5 � dvrva-il�.,,u' y.c�d c-a.tiap�� rn6ov,e. <br />-� u%� �-a,U �r,�v ' b a �� - fv - lo u c�C '��, �► r�vs . <br />PLUMBING <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />I<ilchen sink & disposal <br />Dish��asher <br />Clothes washer <br />Laundry tray <br />Sink (service/bar/mop/etc.) <br />BackOow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />NO. <br />MECHANICAL <br />TYPE OF FIXTURE OR ITEM <br />NC ��. iair handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas freplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhausl fan <br />Heatpump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />Other <br />CIN OF EVERETT LOCAL SALES 7AX CODE IS 3105 <br />I hereby cerili(y iha[ I have read and examined this application and know the same to be true and correct All provisions of laws and <br />ordinaces goveming this type of work will be complied with whether specifed herein or not. The granting of a permit does not presume <br />to give authority lo violate or cancel the provision of any other state or local law regulating constructbn or the perfortnance of <br />construction. That I am authorized by the owner o( ihis property to pedorm the work for which application is made and I comply wiih the <br />State Co ractors Law 18. 7 RCW nd 236200'NAC. <br />(.� w�� � �� �� �l rb 1 �5 <br />