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PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETr, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 FM <br />SITE ADDRESS <br />^`';�l � ��1 I: �� �� �i' 1 <br />L[GAL LOTNO. BLOCK TRACT <br />IDESC. <br />OWNER ADDRE <br />L��\r4 i �(f .l. �1 � �1 � I'„i. i � � i ���- I <br />li TENANTNAME � CONTA <br />CONTRACTOR j11'°I <br />��11 <br />CONTR. LICENSE # ', <br />USE OF BUILDING <br />WORK DESCRIPTION <br />PARCEL TAX I.D. # <br />. n � .., r. ... , �. <br />� � � �� i �n � u.uvu. <br />�� I ��! I A�DRESS —�_ <br />� � �C' �,�'y: ';? %�; <br />1�,� �21 �.� � <br />� HEAT SOURCE <br />`IZrJ-�� ! <br />PHONE <br />qL��-���'U�-C��V <br />CINlZIP PHONE <br />(�r-)iiY�it'�,� li_�(�1 �1��'�=� <br />��.i L"- �ic��l-ILIt��� <br />I CONTRACT PRICE OF WORK <br />_ Electric _, Gas _ Other <br />l�'ir��_��I� 1�,���� �% �'�C��ISr � <br />NO. I TYPE OF FI%TURE OR ITEM <br />lailet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kilchen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />Laundry trey <br />Sink (service/bar/mopletc. ) <br />BackAow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Rocf drains <br />Other <br />NO. I T�'PC� 7F FIXTURE OR ITEM <br />A/C - alr handling units <br />Forced air systems <br />Gas piping <br />Waler heater <br />Gas fireplace <br />Gasrange <br />C!othes dryer <br />Range hood <br />[xhauslfan <br />Heatpump <br />Unit heater <br />Boiler <br />Refrigeretion <br />Woodstove <br />CIN OF EVERETT LOCAL SALES TAX CODE IS 7105 <br />I hereb� ceritify that I have reaA and examined this applicalion and know the same to be We znd correcL All provisions of laws and <br />ordinaces goveming Uiis type of work will be complied with whelher specified herein or not The grantiny of a permit does not presume <br />to give authonty to violate or cancel lhe provision of any other slale or local law regulating conslruction or the performance of <br />cunstruction. 7hat I am authonzed by the owner of this property m pedorn the work for which application is made and I comply with the <br />e <br />