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Seo.22. 2011 7:S1AM No.0763 P. 2 <br />( <br />PERMIT APPLICATION <br />CITY OF EVERETT PERNiIT SERVICES <br />3200 CEDAR STREET, EVERETi, WA 98201 <br />425-257-8610 — FAX 425-257-8857 — www.evereriwa.org <br />31TE ADDRESS <br />151"I � <br />LEGA LOT N0. <br />DESC. <br />NER <br />(�Oi�� <br />�� <br />GtYM t�eu�i nG� 1vtc.. <br />CONIA. LICEN � R <br />USE OF BUILDINp <br />WOftK QESCRIPTION at f Y <br />q�o� <br />pPPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />BLOCK <br />�Nt� <br />PARCEL TAX I.D. A <br />TpACT OR SUBDIVISION II <br />EIu�.�h <br />4Z5 Z59 �o��� <br />�t25 ZSq 6� b b <br />HEAT SOURCE CONTRACT PRICE OF WORK <br />Eledric �Gas _ Other I� G D� ��� <br />9as �, ne -ta -��wc<, H2o ,� fv�re, ro�qc. <br />,'f NO'� W0.�.( "�utiK � ��1SiZ1.� � �P SV���II`S ♦ <br />NO. I TYPE OF Fl)liURE OA 17EM <br />Bathlub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink 8, disposal <br />Dishwasher <br />Clothes washer <br />W ater heater <br />Sink (servicebar/mOp/et�.) <br />Backflaw ptevente� <br />lfrinal <br />Drinking Fountein <br />Floor drain <br />Glease trap <br />Rooldratns <br />atx3r <br />N0. I 7YPE OF FlXTURE OR ITEM <br />A/C — ait hnndling units <br />Forced air systems <br />Gas p�ping <br />wpler heater <br />pes tireplace <br />Gas range <br />Clothes dryer <br />Ranp� hoad <br />Exhaustfan <br />Heatpump <br />Unit heatar <br />Boiler <br />RetrigtraGon <br />Woodsrove <br />pthar f(1 <br />CITY OF EVEflH7T LbCAI. SALES TA1C COD! IS 9105 <br />I hereby Ceritity ihat I have read and A.xamined this application and k�row the same to be true end mrrect. All provisions ot laws and <br />ordinaces governing thic type of vrork wili be complied with whether spCcified herein or not. The grantiny ot p permit does not praume <br />to give euthority to vidate or cancel the provision of any olher stale or local law regulating construcUan or thp paAormanoe ot <br />conshucNon. That I em authorized by the owrrer ot this properly ro perform ths work tor which appliCation is made and I complY wilh the <br />State Contrectors Law t8.27 RCW and 296.200 WAC. <br />