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SITE ADDRESS <br />5Co2 � <br />LEGA LOTNO. <br />DESC. <br />OWNER <br />��� <br />TENANTNAME <br />RMIT APPLICATIUN <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 AN TO 4 PM <br />PARCEL TAI( I.D. A <br />1 BL�'' I TRACT OR SUBDMSION �. <br />ADDRESS <br />C�+ r'JC2 �i �v1SGt � �' <br />ICONTACT FOR PERMR <br />4le�o �.�c�� W�� <br />USE OF 8 LDING HEAT SO <br />I��/1n p _ Electri Gas _ Other <br />�r►� ` <br />WORK DESCRIPTION <br />HAAIL <br />, .► <br />42s=2s�- � r�� <br />CONTRACT PRICE OF WORK <br />32 ��. 7� <br />L�� �� � Fh ,��ti�( re� le� �t��, e�� <br />NO. � TYPE OF FlXTURE OR ITEM <br />Toflel <br />Bathtub <br />Lavetory (wash basin) <br />Shower <br />�tchen sink 8 disposal <br />Dishwasher <br />CbMec washer <br />Water heater <br />Slnk (service/barlmoplelc.) <br />Backflow preventer <br />Urinal <br />Dflnking Fountaln <br />Floor drain <br />Grease trap <br />Rooi drains <br />Olher <br />NO. I TYPE OF FUC7URE OR ITEM <br />A/C - air handling units <br />Forced alr systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Cbthes dryer <br />Range hood <br />E�aust fan <br />Heat pump <br />Unit heate� <br />Boiler <br />Refrigeradon <br />Woodstove <br />ane� <br />CRY OF EVERETT LOCAL SALES TAX CODE Y3 �705 <br />I hereby ceritiry thal I have read and e�mined this appiica6on and knoN• the same to be true and cortect. All provisbns of laws and <br />ordinaces goveming this type ot xrork will be rnmplied with whether spacified herefn or not. The granting of a pertnit does not presume <br />lo give authority to violate or cancel the pravisf�n ot any other stale or bcal law regulating construcdan or Ihe peRortnence of <br />construction. That I am authorized by ihe owner of thts property t� pertortn the work for which appl�aUon is made end I compty wiTh fhe <br />Stete C ract�rs.l.a�+ 18.27 RCW and 296.200 WAC. <br />p �- 2 � -`6 I / <br />