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PEF�MIT APPLICATION <br />CITY OF EVERETT PER�IIITi SEl�VlCES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-885"l - wv,nv.everettwa.org <br />��-T��� �� APPLICAT'.ONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS i n� � PARCEL TAX I.D. # <br />LEGAL LOT NO. � BLOCK <br />DESC. <br />OW NER <br />I�:U��- �f��.�.� <br />TENANTNAME <br />+' �.i <br />.� ,/ <br />CONTRACTOR �i(GK,�y- �^� <br />av <br />CONTR. LICENSE # <br />USE OF BUILOING <br />�,�f\ <br />WORK DESCRIPTION <br />�V� 5��� <br />s �� <br />PLUMBING <br />NO, I TYP[ OF FIXTURE OR ITEM <br />Toilel <br />Bafhlub <br />Lavalory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Laundry lray <br />Sink (service/barlmopletc.) <br />Backflow prevecler <br />Urinal <br />Drinking Founlain <br />Floor drain <br />Grease lrap <br />Roof drains <br />Other _ <br />TRACL <br />���' �� � _c� _�� <br />� <br />ACT <br />UDRESS/" / r]'� C � <br />p� C�o .Iv�¢ .� <br />� dl / .•� • <br />HEATSOURCE' <br />_ Electric ✓ Gas _ OUier <br />Il-J6-os <br />P PHONE �n r <br />� q�',�� ��-z� � 5 <br />PHOIJE <br />� �- �:� — (1 7 �'�'. <br />p PHONE <br />�.-�_ <br />.' . <br />I ONTRACT PRICh UF WORK <br />� �G 5;�_ - <br />�;� �� �/ � <br />J 1 � , ��; <br />>��'7�����a� A2�4 BE�,��,h c <br />MECHANICAL <br />NO. I :�`.'^E OF FIXTURE OR ITEM <br />A/C - :,ir handling unils <br />Forced air syslems <br />Gas pq�ing <br />W ater heater <br />Gas fireplace <br />Gas ranne <br />Clothes dryer <br />Range hood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeretian <br />Woodstove <br />CITY OF EVERETT LOCAL SALES TNi CODE IS 3105 <br />I hereby ceritify that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br />ordinaces yoveming this type of work will be ccmplied wilh ��helher specified herein or noL The granling of a per.mil does not presume <br />lo give authority lo violale or cancel the provision of any other state or local law regulating construction or the performance of <br />const iction. Tha I aqi authorized by the owner o( Ihis property to perfor��i [ne work for which applicalion is made and I compty with the <br />Stale�onU2ctor�! ad+ 18.27 RCVV 2nd 296.200 WAC. , <br />