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Fron:IMAC INC. <br />SITE <br />� <br />LEGA LOT NO. <br />DESG. <br />Ic:91a252578857 <br />i�i2oi3 ia o2 <br />PERMIT AF�PLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425•257-8810 — FAX 425•257•8857 — vnvw.everetitva.org <br />APPLICA710NS ARE ACCEPTED FROM B AM TO 4 PM <br />BLOCK <br />� vc,�� Tr �usi�/G �1c.r�!�; <br />TENANT NMIE <br />'Y �� <br />.............,.,,. ,l,n.�fi��, /NG <br />C01lTA. UCEHSE I /M�e Z *'-*��B� <br />use oF aui�oiNc <br />PARCEL TAX I.D. A <br />TR11CT OR SUBOIYISION! <br />- 27/l� /5���.1'��'r� <br />ruq PEFlMR <br />PHONE <br />N Ctf� ri <br />�l'.va� <br />�:460 N 002/003 <br />lo -�i -/3 <br />'ERMR a <br />'�31�-603 <br />ONE <br />vz, -�3 -�i3� <br />E �IoO <br />S�U/-7o/� <br />— ntAT SOURCE I CODiTRACT PRICE OF WORK <br />✓Elettric ✓Gas Other <br />WOHK DESCRIPTION //k$��(� ��„� ��5�,� S,y�T,UI-� ,' P�UV/� ��,,,J «�.� <br />/i�tl�S f0 ci CL. i�-, k`%�-��S ' - - - - - - <br />NO. � TYPE OF FlXNRE OR fTEN <br />! T011el <br />T Balhtub <br />_L Lavatory (wash bazin) <br />, Shower <br />Kilchen sink 8 disposel <br />' Dishwasher <br />Z Clolhos washcr <br />�y Waler heater <br />Si�k (servico/barlmop/0tc.) <br />Backllow preventcr <br />Urinal <br />Drinkir�q Fountein <br />Floor drain <br />Greaee irep <br />Rool d�alns <br />Olhor <br />NO. � TYPE OF Fl7[TUqE Oq REN <br />w� - an narqimp uniCq <br />Forced alr syslems <br />Gas pipi�g <br />Water heater <br />� Gas Ii�eDlece <br />Gns ranpe <br />Clolhes dryer <br />Ranpe hood <br />F:haustlan <br />� Heatpump <br />Unn neatcr <br />Boller <br />Retrlporatlon <br />Woodstove <br />__ Other <br />CRV OF EVEqETT LOCAL SALES Tq7( CODE iS Jt05 <br />I hcreby centify Ihat I have read anC examined �hls appllWtion ard know thc same lo be Irue and wrreq. All prov�ions ol lews and <br />o�dlnaces governin0 Ihis rype o1 work will �e com0lied with whether spealied herein or nol. The grant�ng ol a permil does not presume <br />to give aul�ority lo violaie or cancel Ihe p�ovision ol any other s�ate or tocal law repuleling conslrucLon o� Ihe pertormante ol <br />coastruction. That I am authoriied by tho ownor ol this property lo peAortn the work for which epp'icalion is medo and I mmply with the <br />sia�e co�uac�ors,�w ta:a7pcw and zsezoo wnc. <br />x� <br />