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SITE ADDRESS <br />C `� <br />LEGAL LOT NO. <br />DE',C. <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425.257-8810 — FAX 425.257-8857 — www,everelfwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />) <br />BLOCK <br />PARCEL TAX I.D. If <br />TRACT OR SUBDIVISION x <br />PERMIT Y <br />ii_'I <br />_ �� I;JsLs�. aL�►y `rs���� Doo't ,F << 0- 1 E ; 5=vim,. <br />TENANT NAME CONTACT FOR PERMIT PHONE <br />EMAIL <br />CONTR. LICENSE • <br />Iewiro,ss �aa o i �► Pay � �, , C�,p U-Qvt-� ww <br />USE OF BUILDING HEAT SOURCE I CONTRACT PRICE OF WORK <br />Electric _ Ode _ Other <br />WORK <br />,DESCRIPTION <br />` <br />NO. I TYPE OF FIXTURE OR ITEM <br />Tollet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />Water healer <br />Sink (servicelbarlmopfatc.) <br />_ Packflaw preventer <br />_Urinal <br />_ Drinking Fountain <br />_ Floor drain <br />_ Grease [rap <br />_ Root drains <br />Other <br />NO, I TYPE OF FIXTURE OR ITEM <br />_ A/C — air handling Lairs <br />_ Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryor <br />Range hood <br />Exhaust fen <br />Heat pump <br />_ Unit heater <br />_ Boller <br />_ Refrigeration <br />_ Woodstove <br />Other <br />CITY OF EVERETT LOCAL BALES TAX CODE IS 3105 <br />hereby coritlfy that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br />trdinaces governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume <br />o give authority to violate or cancel the provision of any other state or local law regulating construction or the performance of <br />:instruction. That I am authorized by the owner of this property to perform the work for which application Is mado and I comply with the <br />'late Contractors Law 18.27 RCW and 296.200 WAC. <br />