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SITE <br />PEaMIT 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 />APPLICAi?JNS ARE ACCEPTED FROM B AM TO 4 PM <br />LOTNO. � BLOCK � TRACT <br />PARCEL TAX I.D. # <br />� 6- 06 <br />`✓FQ���f.,�,��,' � Ffu.t-L��,��u �107 �o/6h�u�� y$.tbL_`1d5-3o3-/I�/ <br />TENANT NAME ONTACT FOR PERMIT PIsONE <br />_Sv-�n c. Sf-evc l�L'P�-� ti'�5 =5�8-65>7 <br />CONTRACTOR ADDRESS CITY2IP PHONE <br />�vE,�E l% /1ac�s,�,�,�fu+M�i�� .�/oT coi�� a.v� qg�ol y3�s=s68=6s/7 <br />CONiR. LICENSE 1t <br />USE OF BUILDING <br />HEATSOURCE <br />Eleclric dGas _ Other <br />CONTRACT PRICE OF WORK <br />�n_ <br />WORKDESCRIPTION ��P���'� /�QGmpQ`� GX�Sj%��� ��������" <br />N0. I TYPE OF FIXTURE OR ITEM <br />Toilel <br />Bathlub <br />Lavalory (wash basin) <br />Shower <br />Kitchen sink 8 disposal <br />Dishwasher <br />Cbthes washer <br />Water heater <br />Sink (serviceNar/mopletc.) <br />Back(low preventer <br />Urinal <br />Drinking Founlain <br />Floor drain <br />Grease Irap <br />Roo( drains <br />Olher <br />NO. I TYPE OF FI%TURE OR ITEM <br />A/C — air handling unils <br />Forced air syslems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gasrange <br />� Clolhes dryer <br />�Range hood <br />Exhaustfan <br />Heat pump <br />Unit healer <br />Boiler <br />Re(rigeralion <br />Woodslove <br />Olher <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 7105 <br />I hereby ceriti(y ihal I have read and examined this application and know the same to be lrue and correcL 411 provisions of laws and <br />ordinaces governing this lype of work will bo complied wilh whether specified herein or not. The granling o( a permit does not presume <br />to give authority to violale or cancel lhe provision ot any other slate or local law regulaling consWction or lhe performance ot <br />construction. That I am aulhorized by the owner of ihis property to peAortn the work tor which applicaGon is made and I comply with the <br />Sfate Oontractors Law 18.27 RCW and 296.200 WAC. <br />