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�� �t'ERMIT APPLICA��ON <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.e deretlwa.org <br />SITE ADDRESS <br />I�a� W � <br />LEGA LOT NO. <br />OESC. <br />TENANTNAME <br />S <br />Neo <br />Grey Po�ey <br />CONTR. LICENSE # <br />T�l1Q <br />USE OF BUILDING <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />BLOCK <br />WORK DESCRIPTION <br />�ecc,r,d 5-�ry <br />PARCEL TAX I.D. M <br />00 ��� 5� ooDa� g�1 <br />TRACT OR SUBDIVISION # <br />CONTACT FOR PERMIT <br />PHONE, t 27� ����{ I ` <br />/2s/z��o <br />����� <br />`t2 g- 3y4—leHB� <br />HEAT SOURCE I CON7RACT PRICE OF WORK <br />,� Electric _ Gas _ Olher J�� <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />BathWb <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Cbthes washer <br />Water heater <br />Sink (service/bar/mop/elc.) <br />BackFlow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Olher <br />� �� <br />N0. I TYPE OF FIXTURE OR ITEM <br />AIC — air handling units <br />Forced air systems <br />Gas piping <br />water neater �� <br />Gas fireplace <br />Gas range <br />Clolhes dryer <br />Range hood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />C�TY OF EVERETT LOCAL SALES TN( CODE IS J105 <br />I hereby ceriti(y that I have read and examined lhis application and know the same to be true and correct. All provisions of laws and <br />ordinaces governing lhis lype of work will be compiied with whether specified herein or nol. The granting oi a permit does not presume <br />to give authority to violate or cancel ihe provision of any other state or locat law regulating construclion or the periormance of <br />construclion. That I am aulhorized by lhe owner of Ihis property to perform the work tor which applicalion is made and I comply with ihe <br />State Conlraclors Law 18.27 FCW and 296.200 WAC. <br />��;����' ��_ �/�/0� � � �3 <br />