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PERMIT APPl.ICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.evereriwa.org <br />APPLICATIONS AHE A�CEPTED FROM 8 AM TO 4 PM <br />SRE ADDRESS <br />LOT NO. <br />C� <br />CONTR. LIC�NSE k <br />USE OF BUILDING <br />WORK DESCRIPTION <br />PARCEL TAX I.D. if <br />TRACT OR SUBDI'JISION t <br />ADDiiESS <br />35���5t. <br />CJNTACT FOR PEHMIT <br />mll� M�-I.�11 � n <br />ZG2 <br />PERMIT if <br />� � — <br />PMONE <br />;QU�O� <br />�o►�E�+z.S_�5 - <br />e•Ma�ilpilV • 11lGla <br />��k�l+���,,L� �6 �as-��3-1�3�3 <br />\'JO6C����vi1\� �1`b6i�2 <br />MEAT SOURCE I CONTRACT PRICE OF WORK <br />Eleciric Gas Other <br />(_:�x��Ql4,}�. C1P,�f`nU�i�iCx� �� �'1CX�'LQ. <br />NO. � TYPE OF Fl%TUflE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washe� <br />Waler heater <br />Sink (service/ba!/mop/etc.) <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Fioof drains <br />Other <br />N0. I TVPE QF FlXTURE OR RE61 <br />A/C — air handling ur:its <br />Forced air systems <br />Gas pipin4� <br />Water heater <br />Gas (ireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaustian <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />CITY OI'• EVERETT LOCAL SdLES TAX CODE IS 3105 <br />I nereby ceritify that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br />ordinaces governing ihis type of work will be complied with whether specified herein or not. The granting of a permit does nol presume <br />to give authority to violate or cance� the provision of any other stale or local law regulating construction or the performance ot <br />construction. That I am authorized by the owner of ihis property to perfonn the work for which application is made arid I compiy with the <br />State Contractors Law 18.27 RCW and 296.200 WAC. <br />