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SITE ADDRESS <br />Z "Z IZC.'C <br />LEGA LOT NO. <br />DESC. <br />OWNER <br />i�'IN%TY LU <br />TENANT NAME <br />� `)�� <br />CONTR. LICENSE M <br />USE OF BUILDING <br />PE�CMIT APPLICATIOIS <br />CITY OF EVERETT PERMI'T SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.everettwa.org . . <br />APPLICATIONS ARE ACCEPTED �ROM 8 AM TO 4 PM <br />PARCEL TAX I.D. M <br />BLOCK TRACT OR SUBDIVISION M <br />I CON'ACT FOR PERMIT <br />�I EL_ G'.9�k'�k�• �' <br />T-.,�,�i CI-I. �SC� <br />HEA7 SOURCE <br />_ Electric �Gas _ O�her <br />WORK DESCRIPTION �1z �a � � <br />r��vGF o F��v� <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />Batht� �b <br />Lavatory (wash basin) <br />Shower <br />1' Kitchen sink 8 disposal <br />T Dishwasher <br />Clolhes washer <br />Water heater <br />Sink (service/bar/mop/elc.) <br />Back9ow preventer <br />Urinal <br />Drinking Founlain <br />�. Floor drain <br />Grease�rap <br />Roo( drains <br />Other <br />PERMIT <br />PHONE <br />CONTRACT PRICE OF WORK <br />NO. I TYPE OF FI%TURE OR ITEM <br />AIC — air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gasrange <br />Clothes dryer <br />Range hood <br />Exhaust fan . <br />Heat pump <br />Unit hea�er <br />Boiler <br />Refrigeration <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE I� 3105 <br />I hereby certity that I have read and examined this application and know Ihe same to be true and correct. All provisions of laws and <br />ordinances governin lhis lype of work will be complied with whether specified herein or not. The granting of a pertnit does not presume <br />to give ay�honty to wlale or cancel ihe provision of any other state or local law regulating construclion or lhe perlormance o( <br />constry�tion. Th I am authorized by the owner of ihis property to perform the work tor which application is made and I comply with the <br />StateContra s Law 18.27 RCW and 296 200 WAC. <br />ol r� <br />