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SITE ADDRESS <br />LOT NO. <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 ARF ACCEPTED FROM 8 AM TO 4 PM <br />PARCEL TAX I.D. # <br />r� <br />BLOCK I TRACT OR SUBUIVISION # <br />PERMIT# <br />I1.' <br />�oU�zi I�'1e-Cnar�t.� 732(0 l-IZlai�c.,t,.ip Dit ��/e�rr �125- 3s3-l3/(0 <br />TENANT NAME CONTACT FOR PERMIT PHONE 2Sj �/U)�-7(j�jS� <br />�12¢ y /���CAf�I liet2. E•MAIL <br />j,�.C�i�.GK C'WiR-AcTcKS <br />CONTR.LICENSE# a.ILC1�CSIOIY�IA <br />USE OF BUILDING <br />HEAT SOURCE <br />_ Electric _ Gas _ Other <br />WORK DESCRIPTION �A 5 r�� L�,�� �XTC� TSo^� <br />NO. <br />u1�LL <br />TYPE OF FIXTURE OR ITEM <br />Toiiet <br />Ba�hlub <br />Lavalory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Waler heater <br />Sink (service/bar/mop/elc.) <br />6ackflow preventer <br />Urina� <br />Drinking Founlain <br />Floor drain <br />Grease irap <br />Roo( drains <br />Olhei <br />CONTRACT PRICE OF WORK <br />NO. I ��YPE OF F�X i URE OR ITEM <br />A/C - air handling unils <br />Forced air syslems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clolhes dryer <br />Range hood <br />Exhausl fan <br />Heat pump <br />Unit hea�er <br />Boiler <br />Refrigeration <br />Woodsto� e <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certify that I have read and examined Ihis application and know the same to be true and correct. All provisions of laws and <br />ordinances governing ihis type of work �vill be complied �vilh whether specifed herein or not. The granting of a permit does not presume <br />to give authorily lo violale or cancel lhe provision of any other slate or local law regulating conslrudion or lhe performance o( <br />conslruction. 'I hat I am authorized by the o��ner of ihis property to perfonn ihe work for which application is made and I comply with lhe <br />S�a(e Conlrad s Law 18.27 RCW a f1296200 WAC ,- <br />2�"/ _ /,x�„ ��/�'/ 7 7 ll% <br />