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SITE ADDRESS <br />LOT NO. <br />DESC. <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 TU 4 PM <br />PARCEL TAX I.D. / <br />BLOCK I TRACT OR SUBDIVISION k <br />o.a - <br />TE!lANT NAME CONTACT FOR PERMIT PHONE <br />� " �'`�rsr�u[tz�( l,//� <br />����A�" �iFE�SP��=�`/ /UI✓ �� E-MAIL �7� —�z/t a/�73� <br />CONTR. <br />USE OF BUILDING <br />WORK DESCRIPTION <br />�t�i� V- %�Ifl%va�� <br />HEATSOURCE <br />� Eleclric _ Gas _ Other <br />CONTRACT PRICE OF WORK <br />I�Pn�u?°-Ct�� .' / �7 NC �J,V�-c"'!GP ���rv� � <br />; ' � (,� . <br />� J � �L �Jc�O�v <br />NO. � TYPE OF FIXTURE OR ITEM <br />J roilel <br />BalhWb <br />_[_ Lavatory (wash basin) <br />_� Shower <br />J_ Kilchen sink 8 disposal <br />Dishwasher <br />Clolhes washer <br />Watcr heatcr <br />Sink (scrvice/barlmop/ela) <br />8ack(low preventer <br />� Urinal <br />Drinking Fountain <br />Floor drain <br />Grease lrap <br />Roof drains <br />Other <br />TYPE OF FIXiURE OR ITEM <br />rVC — air handling units <br />Forced air systems <br />Gas piping <br />Waler heater <br />Gas Tireplace <br />Gas rangn <br />Clolhes dryer <br />Range hood <br />Exhauslfan <br />Heatpump <br />Unit heater <br />Boiler <br />Refrigeralion <br />Woodstove <br />Olher <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />� hereby ceritify Ihal 1 have read and examined this application and know the same to be true and correct. All provisions of laws and <br />ordinaces goveminc� this type ol work will be complied with whether spocified herein or noL The granting o( a permil does not presume <br />to give aulhority to violate or cancel the provision ol any olher state or bcal law regulatinc� construction or the pertormance of <br />wnslruction. Thal I am aulhorized by the owner of lhis property lo perform Ihe work for which application is made and I comply with Ihe <br />Slale Contraclors Law 1827 RCW and 2�J6.200 WAC. <br />