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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 />SITE ADDRESS <br />DESC. <br />nor,L (Z� <br />TENANT NAME <br />MO <br />CONTR. LIC NSE 0 _ <br />USEOF BUILDING <br />All <br />WORK DESCRIPTION <br />/LUc'1 r� <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PARCEL TAX I.D.1t <br />BLOCK TRACTOR SUBDIVISION M <br />CONTACT FOR PERMIT <br />JAX-Je <br />y,d/°L cJ <br />HEATSOURCE <br />_-Electric —_Gas <br />O/J /4-'oo <br />NO. I TYPE OF FIXTURE OR ITEM <br />_ Toilet <br />_ Bathtub <br />_ Lavatory (wash basin) <br />_ Shower <br />_ Kitchen sink 8 disposal <br />_ Dishwasher <br />_ Clothes washer <br />_ Water heater <br />_ Sink (serviceroar/mop/etc.) <br />_ Backflow preventer <br />_ Urinal <br />_ Drinking Fountain <br />_ Floor drain <br />_ Grease trap <br />_ Roof drains <br />Other <br />I hereby certify that I <br />ordinances governin <br />to give authority to v <br />conslruci�n. That I r <br />Slate Cgpiractors <br />/ 2-/-ld <br />DOf <br />PHONE <br />�S-3rb'-a5� <br />EMAIL <br />�TTPIZIIs <br />+,"vd 410j--7,13-77o3 <br />noil I <br />CONTRACT PRICE OF WORK <br />�J <br />Other 73 r; 7 <br />/1.Z-rl <br />MECHANICAL <br />NO. I TYPE OF FIXTURE OR ITEM <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 healer <br />_ Boiler <br />_ Refrigeration <br />_ Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />rve read and examined this application and know the same to be true and correct. All provisions of laws and <br />his type of work will be complied with whether specified herein or not. The granting of a permit does not presume <br />ate or cancel the provision of any other state or local law regulating construction or the performance of <br />authorized by the owner of this property to perform the work for which application is made and I comply with the <br />18.27 RCW and 296,200 WAC. <br />/Z -/- /O <br />