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Oc t. 5. 2012 7: OQAM No. 5365 P. 4 <br />( (. <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 />SITHAnDn ^ � �1''G�m�i�, <br />d.d�• F'� <br />i.Ecn LOTNO. BLOCK <br />� I ppRCEL TAX I�D. N <br />%Ino�vles Cx�u <br />'ENAN7NAME <br />cm ea nqlnc. �►+�5. <br />:ONTR�L C SE , ` h - /j ' <br />U �\ <br />USE OF BUILDINQ <br />OH <br />Ev e�rett <br />HEATSQUflCE <br />/ <br />_ Eleclric � Gas _ Olher <br />RMIT �Y <br />�1121�- <br />. , <br />r . <br />�42525� �6 � <br />CONTRACT PRICE OF WORK <br />I Z �'�� 00 <br />WORK DESCFIIPTION ' <br />�i�nqr�s U� � Insiu►1 c.ust��� 9as �.�t <br />N0. I 1'YF6 OF Fl%TURE OR �7EM <br />Bathlub <br />r Lavalory (wash hdsln) <br />Shower <br />� Kitchen einh & dicpoial <br />Dishwasher <br />Clothes washer <br />� Wetorheater <br />Sink (serviCelBar/mOp/elc.) <br />B2ckllow prevenler <br />Urinal <br />Drinking Founta�n <br />Floor drain <br />GreOse trsp <br />� Rool drains <br />Olher <br />NO. I TYPE OF FIX7URE OR ITEM <br />A/C — alr handling � <br />Forced air tystems <br />(ie� pipinp <br />Water h�atar <br />Oas lireplpGe <br />Gas ranpe <br />Clothes dryor <br />Ranpe hood <br />Exhaustfan <br />Healpump <br />Unit heatet <br />Boiler <br />Retriperalion <br />Woodstove <br />CITY OF EVEREiT LOCAL SALES TAX COGE 13 �105 <br />I hereby ceritity Ihat I have read and exemined Ihls application and know Ihe eam� to be lrua a�d Correct. All provlsions ol laws and <br />ordinaces floveminp this type ol wOrk wlll be complled wilh whethar tp�cifi�d herein or not. The grantlnp of a permit does nol presumo <br />to pive aulhorily to violate or cancel the provlslon ol any olhar ttala Or Ioeei Ipw repulatlnq constructlon or the pertorman�e of <br />construction. That I am authoriz�d by the owner of Ihis property to pertorm th� wOrk lor whlch eppllcatlon Is made and I comply wilh the <br />State Contradors Law 18•27 RCW and 296.200 WAC. <br />�\ . • � � li - - - . i� G : �e <br />