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SITE ADDRESS <br />LOT N0. <br />fiESC. <br />( <br />APPLICATIONS ARE ACCEPTED FRvM 8 Ai.' TO 4 PM <br />PARCEL TAX i.D. # <br />a�� 4Ia� �J9 2Z�S180o3C <br />� gLpCI� TRAC70RSUBDIVISIONk <br />J��"iewt� J"IE7iJY> -J-v��- � <br />TENANTNAME <br />i111 OI re��Vl e � �� �� <br />a4dJaaceo� S��yS LLC <br />CONTR. LICENSE 6 � �� � ^ , I C / � � ? <br />fI N.�L J <br />USE OF'BUILDING <br />Ir�reG��,c �rc{�, <br />WORK DESCRIPTION <br />�nSf�tll �llu�''''I <br />J�I .��yG <br />ICONTACT <br />Ml S��Gi <br />PERMI7 <br />/ . <br />y a� <br />; �Df�-%2� <br />PERMIT# _ <br />)� <br />{� `�� i� � �-i� S� S t �#' 3� �, �,,�V�, �J R'ta <br />HEAT SOURCE CONTR' 'RICE OF WORK <br />_ eiearic _ Gas _ Ome� _ �� I � � -, z . lri� <br />�3/�/'� <br />C�ar��9e� � e <br />NO. I TYPF OF FI%TURE OR ITEM <br />Tollel <br />Oathtu6 <br />Lav;dpry (wa5h baSin) <br />Shower <br />KilCl�on slnk & di5posoi <br />Dishwasher <br />Clothes washer <br />Waicr hua�cr <br />Sink (service/Gadmapletc.l <br />Backllow prevcnlcr <br />UrinPl <br />Drinking Fountain <br />Floor drain <br />Grei�se lrap <br />RoN tlrains <br />Other <br />cJq /� s �e�N <br />N0. I T'PC OF FU(TURE OR ITEM <br />AIC — aif h0ntlling Uni[5 <br />forr,ed air systems <br />� Gas piping <br />� Watcr hCatcr <br />Gas fireplaw <br />Gasrangc <br />Ctolhas dryer <br />� Rangc hood <br />Exhau,l�2n <br />Eieat numn <br />Unif heater <br />Boil�ir <br />ROTdgeration <br />— woodstove <br />Q�hO� <br />CITY OF EVERETT IOCAL SALES TAX CODE IS 9705 <br />1 herehy cerlGly thai 1 havu �oad and oz�icnlnetl this appllcallon a�U know the same l0 6e true antl corcect. AI� provisions ot Isw� antl <br />orclinaCflS govoming this lype of work will Ue complied witb whetlier specified herein or twL The grantir� ot a permit tloes nol Gresume <br />to qivo authoriry lo �iNal� or cancel tho provision of any c+ther stat� or lor.�� 12w reguiating censWction or the pertormonce of <br />c.�nstractioni Th�f I 2�n aulhorized by th� owner of this property W perfom� 1he work for which app6wtlon is maCe and 1 comply wilh lhe <br />State Coqtractors Law 16.27 R��C ��ntl 2�6.200 WAC. <br />l.� S�z1.t�� $ - 2 /- O `� <br />Aidhoriz.�rl Aganl Oolc ll 'z <br />