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PE,IMIT APPLICATIOii <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />25-257-8810 - FAX 425-257-8857 - www.everettNa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />PARCEL TAX I.D.# PE MITE# �} <br />SITE ADDRESS 013 4 .5 a,00(30 16 0c) ) C 2J <br />c 7 3r�Q �7- <br />LEGA LOT NO. BLOCK <br />DESC. / <br />/ l0 Old <br />OWNER <br />C (A.-O I;I 1 JL. n W 1 1 1 .6• s <br />37o-73rA <br />TENANT NAME CONTACT FOR PERMIT PHONE <br />uw�.✓ P .l` VIA^ SIYck qzS t;-7o gylz <br />CONTRACTOR <br />ADDRESS CITYIZIP PHONE <br />AIv Spy c1c— .05SUL keNICS ,A)L. Po, rsox 13000 rcvc ti 987o6 <br />CONTR. LICENSE # <br />USE OF BUILDING <br />SF rk-c5. <br />21 D <br />HEATSOURCE <br />—Electric AGas _ Other <br />'/t4 Stu yylz, <br />CONTRACT PRICE OF WORK <br />Su,UJ(', <br />WORK DESCRIPTION <br />ZA)o FLdOlL ��! rl,'o•• l �1fr., .QXi ens, r� <br />PLUMBING <br />NO. TYPE OF FIXTURE OR ITEM <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />I / <br />Toilet <br />Bathtub <br />Lavatory (wash bast„, <br />Shcwer <br />Kitchen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />Laundry tray <br />Sink (servicelbarlmopletc.) <br />Backfiow prevenler <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />_ <br />1 _�' <br />( <br />_ <br />1 _ <br />A/C — air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boller <br />Refrigeration <br />Woodslove <br />Other <br />f <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />_ <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby cadtity, that I have read and exsmli,c^! :,Is application and know the same to be true and correct. All provisions of laws and <br />ordinates govemi g this type of work will be complied with whether specified herein or not. The granting of a permit does not presume <br />to give authori violate ofedeby l the provision of any other state or local law regulating construction or the performance of <br />construction. I arrk� a tthe owner of this property to perform the work for which application is made and I comply with the <br />State Contra s aw11�2and 296.200 WAC. <br />