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{ <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, [V[R[TT,WA 98201 <br /> 425-257-8810- PAX 425-257-8857-www.everetiwa.org <br /> APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM _ � S--� <br /> SITE ADDRESS PARCEL TAX I.D� PERMIT A <br /> 4`1/S ,f'vuN� R��N �� 005'] � �o0 13 �0 '�� �` - <br /> LCGAL LOTNO. �� BLOCK TRACTOPSUBDIVISIONu <br /> u�sc. 13 �r�� Do�- SH�R-a /►�cri�.r A-oa �Tia� <br /> OWNER ADDHESS CITV2IP PMONE <br /> Ror3ERT Mcl�B � Q-91 � .!'uvw,p �3 �V��T c�$2o3 <br /> TENANTNAME I CONTACTFORPERMIT PHOHE <br /> 340 • 34"7,s <br /> �M1E� b�YT�R E�AIAIL TrT.IO�qY{.�,�' <br /> CONTRACTOR � ADDRESS n CITYgIP PMONE qT� � �p s � <br /> t• 6. D. �%/,�c' LtJ_z�L'�����C,�c%i�s't �nL. �2'�-�'�U- <br /> CONTR.LICENS ,� <br /> -nG � �z� lk�c� .��r�1 ��'� �z����,� ��o� <br /> USE OF BUILDIN��i7��(,V��� '�� HEAT SOURCE CONTRACT PRICE OF WORK <br /> �GS1 n C "� ( l: _Glectiic x Gn; Other � � �� <br /> WORK DESCRIPTION �`� ` ^�� �,�) <br /> �7FLoN () �l.ow't �-�D 1 Tt p� V „�I �. <br /> 1� N- <br /> ^ �XTCRtofl R�£�./.✓!t-rr o... S ,�.�L� 1 � .f,�� 7 <br /> � i l, �� �C S� <br /> PLUMBING � ' n� 1� ME HANICAL <br /> NO. TYPE OF FIX7URE Oq ITEM NO. � �N TYPE OF FI1(TURE OR I7EM <br /> Toilel AiC-� ir handiiny units <br /> l3athiub Foiced air systems <br /> Lavatory(wa,h b,isinl Gas pipiny <br /> Showei Water lieater <br /> Ki�clicn sink R dr.;�x�s.tl Gas tireplace <br /> DishWaSha Gas renge <br /> Clo�hes�vasher Clolhes dryer <br /> W,�tor heatoi Range hood <br /> Sink �service�b:u.mup'elcJ [shaus�tan <br /> l3acktlow preveniei f leal pump <br /> Utinel Unil heaier <br /> Diinhinq PuUnl;tin Bodei <br /> Flooi diain Rehiyera�ion <br /> Grease hap W oodstove <br /> Ronl drain; Oihei <br /> Oth•!i <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 7105 <br /> I heieby a+iitity Ihat I havc ie;�d and eruminud ihis application anA know�he same lo be tiue and conecl. All provisions of laws and <br /> oidinaces��w�ininy Ihis typc ol woih will ba cumpiicd w�th���hether s�xcitied heiein or not.7 he gianting ol a{ximit does not presume <br /> �o give authoii(y lo viol;ite oi cancel Ihe p�ovlsion ot any other stat�or local law reyulatiny constiucuon or the pe�toimance of <br /> construction. Tha� I ain authuiized by ihe owner ot this pioperty to pertonn ihe woik lor whir.h application is made and I comply wilh the <br /> Stat�Contradois Law 1 .�'7 RCW and?JG200 WAC. <br /> I � n-. 2. � ; . o <br /> tii��u,t�ue ol Owne COntr.1 �ocAuihoti2ed t�gent Uale �/ <br /> � � <br />