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4531 5TH DR SE 2016-01-01 MF Import
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4531 5TH DR SE 2016-01-01 MF Import
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Last modified
4/3/2017 10:52:30 AM
Creation date
4/3/2017 10:52:25 AM
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Address Document
Street Name
5TH DR SE
Street Number
4531
Imported From Microfiche
Yes
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P��r�MIT APPLICATIG�� <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810— FAX 425-257-8857—www.everettwa.org �� �D� - �3 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT& CREDIT CARDS ARE NOT ACCEPTED <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT# <br /> '� � 1 / S�� �j� � _ c� S3 / r� o3v J � a � �� �Dg • D�- 1 <br /> LEGA LOT N0. BLOCK TRACT �� <br /> DESC. ��1�f,C <br /> OWNER ADDRESS CITY/ZIP PHONE <br /> �s�.l� ��i���e� �� �- ��U ��f y/o , �� � l�J a ri'� z .� G <br /> TENANTNAME I CONT 7F0 PERM�T � � PHONE <br /> ��5 �d r� �1S- �J8 •- B .iz 7� <br /> CONTRACTOR pDDRESS CITY2IP PHONE <br /> CONTR.LICENSE�.�� <br /> J <br /> USE OF BUILDING I — HEAT SOURCE I CONTl2ACT PRICE OF 1NORK <br /> �'� � Electric Gas Other <br /> WORK DESCRIP710N <br /> ��_ / ��s iL /�S <br /> /!/..�.�,, SF� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM N0. TYPE OF FIXTURE OR ITEM <br /> � +' Toilet A/C—air handliny units <br /> 2 Bathtub � Forced air systems <br /> � Lavatory(wash basin) Gas piping <br /> �L Shower Waterheater <br /> � Kitchen sink 8 disposal Gas firepiace <br /> � Dishwasher Pas range <br /> L Clothes washer � Clothes dryer <br /> _ Laundry tray Range hood <br /> Sink(service/bar/mop/etc.) / � Exhaust fan <br /> � 6ackflow prev=nter Heat pump <br /> I = Urinal = Unit heater <br /> Drinking Fountain Boiler <br /> Floor drein Ref�igeration <br /> Grease trep Woodstove <br /> J Roof drains Other <br /> '/ Other <br /> � <br /> CITY OF EVERE7T LOCAL SALES 7AX CODE IS J105 <br /> I hereby ceriti(y that I have read and examined lhis application and know the same to be true and correct. All provisions of laws and <br /> ordinaces�oveming this rype of work will be complied wiin wlirih�r;pecified herein or not.The granting of a permit does not presume <br />� to give authoriry to violate or cancel the provision of any other state o�'local law regulating construc�lon or the performance of <br /> constn�ction.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�j ont,rac�°rs Law 1827 RCW and 296200 WAC. <br /> l,�r�' � �� � m 9-,�o- d;� <br /> Sig�nature of w e/ on[ractorlAuthorized Agent Date i L <br /> i � <br />
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