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P179MIT APPLICATIC.N <br />CITY OF EVERETT PERMIT SERVICES <br />j200 CEDAR STREET, EVERETT, WA 96201 <br />425-257-8810 - FAX 425-257.8857 <br />KLE�� <br />DRESS PARCEL TAX I.D. 0 PERMIT 0 <br />Ev-elrekk V10-A I4b, 1 o <br />LOT NO. BLOCK TRACT �Ip PHONE <br />OWNER ADDRESS <br />TENANT HALE <br />CONTACT NAME PHONE <br />t-1Z:�> L1fs1-7to LA <br />ADDRESS ZIP CONTR. LICENSE e <br />CONTRACTOR `� Vfowcarlo,0, Iv1C L-Iq3�_ vo. \y1ifYvr6cy) g1vd. -go wtjFpoO <br />I" cover\ � e W\64, q $�012- <br />PHONE L <br />l-2S 1_��1- voioq <br />Building Mechanical AOCition I HEAT SOURCE <br />PROPOSED USE OF BUILDING [ Electric <br />�e��\` ST-y1 C� PERMIT B Combination Plumbing WORK Nleeratron B Gas <br />l r �^ I TYPE Lj Detinkler U 519n TYPE pepainMa�nt. Other <br />Sprinkler <br />WORK 2j; CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />CONTRACT PRICE OF <br />WORK DESCRIPTION <br />PLUMBING MECHANICAL <br />NO, TYPE OF FIXTURE OR ITEM <br />NO. TYPE OF FIXTURE OR ITEM <br />_ WATER CLOSET A/C - AIHANDLING UNITS <br />_ FORCED AIR SYSTEMS <br />BATHTUB <br />_ LAVATORY (WASH BASIN) HEAT PUMP <br />UNIT HEATERS <br />SHOWER <br />_ KITCHEN SINK 8 DISPOSAL CLOTHES DRYER <br />_ RANGE HOOD <br />DISHWASHER <br />_ WATER HEATER <br />LAUNDRY TRAY <br />_ CLOTHES WASHER METAL STOVE <br />E <br />_ URINAL FIREPLACE INSERT <br />GAS FIREPLACE <br />DRINKING FOUNTAIN <br />_GAS RANGE <br />FLOOR DRAIN GAS PIPING <br />_ BACKFLOW PREVENTER EXHAUST FAN <br />_ SINK (SERVICE/BAR/MOP/ETC.) OTHER <br />OTHER <br />1 HEREBY CERITIFY THAT i HAVE READ AND EXAMINED THIS APPLICATION AND KNOW HE SAME TO BE TRUE AND CORRECT. AL <br />PROVISIONS OF LAWS AND ORIOINACES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />STHE OF ANY T THE GRANT <br />OR LOCALING LAW REGULATING CONSTRUCTOF A PERMIT DOES NOT PRESUME CANCELTO GIVE AUTHORITY TO VIOLATE OR ION OR HE P RFORMAN E OF CO STR CT ON.HAT AM AUTHORIZEDPROVISION BY HE OTHER <br />OWNER OF HIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />,nNrFtACTORS LAW 18.Z7 RCN AND, 98200 WAC. / r ^ <br />❑r <br />LL <br />