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( <br />t_ <br />PERMIT APPLICATION <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 <br />SITE ADDRESS <br />�5'7 Lo<uS r <br />LOT NO. <br />7ENANTNAME <br />Sl���� <br />BLOCK <br />!/�'e-'�i/e��%"G AvTf/a/iry <br />CONTR. LICENSE # <br />USE OF BUILDING <br />� <br />PARCEL TAX I.D. # <br />.f 2 —O�/—ODc <br />TRACT OR SUBDMSION # <br />'�n7 ��YAd� <br />CONTACT FOR PERMIT <br />�Qo�/ itiF��' <br />��-�--/� <br />�/dlZ DO�S <br />�� �2r. 303. /rZ� <br />PHON <br />�i.r o� 6390 <br />E-MAIL <br />— HEATS CF_ I CONTRAGTPRIGEUhWVRK <br />Electric _ Gas _ Other <br />WORK DESCRIPTION <br />���r9�.�/i��'�ioG�C �/ST�/(, - .fi� Tf%�.e/ZATo/t/ <br />PLUMBING <br />NO. I TYPE OF PIXTURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clolhes washer <br />Water heater <br />Sink (service/bar/mop/etc.) <br />Backflow preventet <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease irap <br />Roof drains <br />Other <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C – air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 7105 <br />I hereby cert�fy that I have read and examined this application and know the same to be true and cortect. All provisions of laws and <br />ordinances governing this type of work will be complied with whether specified herein or not. The gran6ng of a pertnit does not presume <br />to give aulhority lo violate or cancel the provision oi any olher state or local law regulaiing construction or lhe perfortnance of <br />construclion. That I am authorized by the o�vner of this property to perfortn the work (or which application is made end I comply with the <br />Slate Co �827 RCW and 296.200 WAC. ��— /—�D <br />a <br />