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PE( MIT APPLICAT101q <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.eve;ettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />SITE ADDRES <br />f <br />PARC L TAX I.D. p PERMIT Ai <br />��0�> <br />L /U� <br />LEGAL LOT NO. <br />DESC. <br />BLOCK TRACT <br />t/ , <br />3 <br />UVVNE'R ADDRESS CITY/ZIP PHONE <br />✓�/��el <br />TENANT NAME I CONTACT FOR PERMIT PHONE <br />CONTRACTOR ADDRESS CITY/ZIP PHONE <br />CONTR. LICENSE 0 <br />USE OF BUILDING I HEAT ;OURCE CONTRACT PRICE OF WORK <br />Electric Gas Other <br />WORK DESCRIPTION i- <br />PLUMBING <br />MECHANICAL <br />N .. TYPE OF FIXTURE OR ITEM. <br />NO. TYPE OF FIXTURE OR ITEM <br />Toilet <br />A/C — air handling units <br />Bathtub <br />Forced air systems <br />Lavatory (wash basin) <br />Gas piping <br />Shower <br />Water heater <br />Kitchen sink & disposal <br />__ <br />Gas fireplace <br />Dishwasher <br />Gas range <br />Clothes washer <br />Clothes dryer <br />Laundry tray <br />Range hood <br />_ <br />Sink (service/bar/mop/etc.) <br />Exhaust fan <br />Backflow preventer <br />Heat pump <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodslove <br />Other <br />_ <br />_ <br />_ <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3108 <br />I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br />ordinates governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume <br />to give authority to violate or cancel the provision of any other state or local law regulating construction or the performance of <br />construction. That I am authorized by the owner of this property to perform the work for which application is made and I comply with the <br />Stal o ractors aw 18.27 R and 296.200 WAC. <br />!7Oe <br />5vgna ui reI QvvnevContraClCT7AUtIhon�0Agent atd <br />