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PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> 425 257-8810-FAX 425.257-8857-www.evetettwe Org <br /> APPLICATIONS ARE ACCEPTED FROM S AM TO 4 PM <br /> SITE ADDRESS PARCEL TAX I.D.0 PERMIT <br /> p�'^ k �vereir <br /> On 10 '2- <br /> jn'Ilr��l -USS <br /> LE LOT NO. BLOCK TRACT <br /> DESC. CrtYIDP ►Noes <br /> -�N AOD <br /> C�(J� I-99"3 z.- 3`6 <br /> TENANT RAMI CONTACT FOR PERMIT PlgNE <br /> m IcFle,�e <br /> CO�RMOTOR ADDRESS CIryRI► PHONE <br /> qZo-,k,,o d�., A, -awt 20t,•17,6-1am <br /> CONrn LICEMSF e WA- `181k% <br /> USE OF BUILDING I — HEAT SOURCE CONTRACT PRICE OF WORK <br /> Electric _Gal xOmer 0,� ) <br /> WORK DESCRIPTION <br /> Ss, ra oo @rIPA U <br /> PLUMBING MECHANICAL <br /> RO, TYPE OF FIXTURE on REM NO. TYPE OF FIXTURS OR REM - <br /> Toilet A/C-sit handling units <br /> —_ Bs1tINb Farad air systems <br /> Lavatory(wash brwin) -- Gas piping <br /> —_ Shower Water header <br /> _ Pachan sink 6 disposal Gas fireplea <br /> _ Dishwasher omranix <br /> Ciotti"washer Clothes dryer <br /> Laundry trey Range hood <br /> Sink(NMO01barAtlOpf ) Exhaust tan <br /> _ Backllow provenler Haat pump <br /> Urinal Unit heater <br /> Drinking Fou n Boiler <br /> Floor dial Reft"ration <br /> _ Grew _, WdOdltOVe <br /> _ R mina purer e-iD, <br /> r — <br /> CITY OF EVERETT LOCAL SALES TAX CODA IS 8104 <br /> I hereby cert iry that I have read and ekamlnsd this application and know the all to be bus and correct. AN provisions of Iowa and <br /> ordinsae gOveming this type of work will be comped with wtle#w 2ped6ed herein or riot The granting of a pentyl does not preslmra <br /> t0 gate authority to violate Or anal G9 provislon of any other stale or local law regulatlltg Construction of SN performance of <br /> con"Jon.That I sm authorized by the owner of this property 10 pirform the work for which application Is made and I comply with the <br /> State Contredmai Law 16 27 RSC(W and 296.200 WAC. <br /> n <br /> pins pentLmta <br />