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P"RMIT 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 ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />SITE ADDRESS PARCEL liP,X I.D. # <br />' EVGftt'f'; PE IT# <br />lU )3 cc) 5 f. S w, w�.. 98,W3 6 23-Q5 _ `•. 2 `/ _ _ 12, <br />5�� <br />-EGA LOT NO. I BLOCK TRACT <br />keuin 144el0. PmIe Oto 73rd. S+-' S.w. E=uerejY,y8do3 Nis 3�y7 Gog/ <br />TENANT NAME CONTACT FOR PERMIT PHONE <br />Sck_The IKeuin NL11 t/2S'3y7C-o81� //22 t7ss�/ <br />CONTRACTOR ADDRESS CITY2IP PHONE <br />11oriie owner <br />CONTR. LICENSE# <br />USE OF BUILDING <br />WORK DESCRIPTION <br />A 6 )ulI Po�Cd in place CLIc irN,r\g_ Wt �I� Wlfiv Sirut5 f1, j0oTe paumc IY\ <br />1'I" e_ 4 0. Stub of\ gcc, . <br />HEAT SOURCE CONTRACT PRICE OF WORK <br />_ Electric _Gas _ Other I 11 <br />r )'co <br />PLUMBING MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM _T NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Laundry tray <br />Sink (servicelbar/mop/etc.) <br />BackBow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />AIL; — 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 />Heal pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby cerifify 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 compiled with whether specified heroin 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 />State Contractors Law 18.27 RCW and 296.200 WAC. <br />C"-�j <br />