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SITE ADDRESS �/� 1Q' <br />�1 v <br />LEGAL LOT N0. � �, \ <br />TENAN7 NAME <br />F'� :RMIT APPLICATIC V <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEt]AR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.evereriwa.org <br />APPLICAl'IONS ARE ACCEPTED hROM 8 AM T04 PM <br />BLOCK I TRACT <br />CONTRACTOR �,r,Q,,,� <br />coNrn. <br />USE OF BUILDING <br />PARCEL TAX I.D.11 <br />�/i/E �/oz <br />ICONTACTFORPERMIT <br />�rP�t'�[a � <br />p�on_aess cirvrnr y� "�S3 <br />9si� ,�.� �t/�/� ��'�i� <br />PERMIT N <br />;�,, , � - F'�— '(� <br />PHONE <br />-_�xu _ <br />WORK D SCF R�F'T��N �� ,!; , / <br />e%�lJLe� <br />NO. � TYPE OF FIxTURE OR ITEM <br />� Toilet <br />Bethtub <br />Levelory (wash besin) <br />I. Shower <br />� Kitchen sink & disposal <br />� Dlahwasher <br />Clothes wasfier <br />Leundry lrey <br />Sink (service/ber/mopletc,) <br />Backflow preventer <br />Urinel <br />_ Drinkingfountein <br />_ Floor drein <br />Greese trep <br />Roo1 dreins <br />Other <br />i�70 <br />w� <br />FIEAT SOURCE CONTRACT PRict ur wunn <br />Eledric ✓ Ges _ Other <br />N0. I 7YPE OF FI%TURE OR ITEM <br />A/C — alr hendling unfts <br />Forced eir syslems <br />Gas piping <br />Water heeler <br />Gae fueplace <br />Gas renge <br />Clothas dryer <br />Renge hood <br />Exheusl len <br />Heel pump <br />Unll heeter <br />Boller <br />RefAgeretion <br />Woodslove <br />Other — <br />CITY OF EVERETT LOCAL BALES TA% CODE IS ]tOb <br />I hereby ceri6(y thef I heve read end exemined this applicaUon and know tha seme to be true end cottecl. All provlsions of lews end <br />ordineces goveming lhis type oi work will be eomplled with whether apedfied hereln or not. The grenting o1 a pemt�l does not presume <br />to give euthority to vlolate or cancel the provislon oi eny olher atele o�ortnllhe vrork lornwhich appl cieti nr Is mede e dBl comply w��h ihe <br />canstrucllon. That I em euthorized by the ownet of this property to pe <br />Stete ConVectors Lew 18.27 RCW end 2B6.200 WAC. <br />.�'-,� �>-�_--c� �--� z��6 � `�z <br />