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SITE ADDRESS <br />14]�dGll <br />��/� <br />TENANTNAME <br />��tRMIT APPLICATIC�N <br />CITY OF EVERETT PERMIT SERVICES <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 ) h•�J I`-� � <br />CUS% <br />BLOCK <br />CONTR. LICENSE # �y� <br />USE OF BUILDING <br />S�/C <br />WORK DESCRIPTION <br />NO. <br />/�E-���I�//�;41_ <br />� <br />PARCEL TAX I.D. # PERMIT # <br />.5- � - DO - Do��-n.n� D�i�-ool <br />TRACT OR SUBDIVISION # <br />AUDRESS CITY/ZIP PHONE <br />CONTACT FOR PERMIT PHONE <br />��r�/ N�f,� (/�� Mso� 639d <br />HEATSOURCE <br />Electric t� Gas Olher <br />- ,�E-�'.9/,F/��/'94/J�L <br />TYPE OF FIXTURE OR ITEM <br />Toilet <br />Balhtub <br />Lavalory (wash basin) <br />Shower <br />Kilchen sink & disposal <br />Dishwasher <br />Clolhes washer <br />Waler heater <br />Sink (service/bar/mop/etc.) <br />BacRflow prevenler <br />Urinal <br />Drinking Founlain <br />Floor drain <br />Grease trap <br />Root drains <br />Olher <br />CONTRACT PRICE OF WORK <br />vD• � <br />NO. I TYPE OF FIXTURE OR ITEM <br />NC — air handlinc� unils <br />ForceJ air systems <br />� Gas piping <br />1_ Waler healer <br />Gas (ireplace <br />Gas range <br />� Clathes dryer <br />1 Range hood <br />� Exhausl fan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />CIN OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby ceritify Ihal I have read and examined lhis application and know the same lo be true and correcL All provisions of laws and <br />ordinaces governing this type of work will be complied with �vhether speci(ied herein or nol The granting of a permit does not presume <br />lo yive authority to violate or cancel the provision of any olher state or local law reaulating conslruction or the performance of <br />construclion. That I am authorized 6y lhe owner of ihis property to pertorm Ihe work for which application is made and I comply with the <br />State Conlr�tqt�.j_aw 18.27 RCW and 296.200 WAC. <br />