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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.everettwa.org <br /> APPLICATIONS ARE ACCF ,TED FROM S AM TO 4 PM <br /> SITE ADDRESS EL TAX I.D.# PTJ�� <br /> LE LOT NO. BLOC6TIIACT <br /> OWNER ADDRESS CITY2'P PHONE <br /> TENANT NAME I CONTACT FOR PERMIT HONE <br /> c ��� <br /> r yas <br /> CONTPACTOR ADDRESS CITY21 <br /> l�c�y/,yyvD���,-r�.r� Y CO.✓TRAGT�G 3/YlXw7C /� CvG7c/r4,4 9d•7/� <br /> CONTR.LICENSE« -3-07 U7 <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> Electric Gas_Other j 7�00 <br /> �J�Pi�•x — - — <br /> WORK DESCRIPTION <br /> ,A AJ A11,e4x <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet A/C-air handling units <br /> Bathtub ' Firced air systems✓' <br /> Lavatory(wash basin) .% Gas piplr <br /> __ Shower✓ Watn•heater✓ <br /> 2 Kitchen sink 8 disposal Gas fireplace <br /> 3 Dishwasher . L Gasrange,� <br /> Z Clothes washer Clothes dryer <br /> Z Water heater Range hood <br /> _fes Sink(servloelbar/mopletc.) ExhLust fen <br /> Backflow prevenler Heat pump <br /> Urinal Unit heater <br /> Drinking Fountain Boiler <br /> Floor drain Refrigeration <br /> Grease trap a- Woodslove <br /> Roof drains Other _ <br /> Other — — <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 7105 <br /> I hereby cerltify that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br /> ordinates goven,ing this type of work will be compiled with whether specified herein or not.The granting of a permit does not presume <br /> to:Ive authority to violate or cancel the provision of any other state or local law regulating construction or the performance of <br /> construction. a sufforized Whe owner of this property to perform the work for which application Is mane and I comply with the <br /> State Contorgnd 296.200 WAC. <br /> / <br /> r / <br /> ' <br /> natur er ontraolorAothoHzza AgentDate <br />