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! ( <br /> � ERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 - www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM � `�0 —�� <br /> SITE ADDRESS PARCEL TAX I.D. q PERMIT a <br /> 1310 PACiFIC AVE 00437573400102 � � �� � ,�Z <br /> LCGAL LOT NO. BLOCK TRACT OR SUBDIVISION a <br /> oesc. seeattached <br /> OWNER ADDRE55 CITY2IP PHON( <br /> PACIFIC AVENUE HOLDINGS LLC �� PO BOX 1798--- STANWOOD,WA 98292 <br /> i�vnNr NnMe coNrncl rox rERMiT vi{oNE 425-776-8835 <br /> Central Body Works Tracie Skiles newperm�ts,sbenyneonsiqnscom <br /> C MAII <br /> CONINAUON �DDRLSS UTY21P PHONt <br /> BERRY NEON SIGN SYSTEMS 7400 Hardeson Rd, Everett,WA 98203 425-776-8835 <br /> coNre. uceNsek BERRRYNC077Ch4 <br /> USE OF BUILDIf�G I1EAT SOURC[ ( CONTRACT PRICE OF WORK <br /> COMMERICAL Elec,ric __ Gas ___ omer $U,084.00 <br /> WORK OESCRIPTION <br /> INSTALL 3 lit wall sign <br /> PLUMBIIJG MECHANICF,L <br /> NO. 1YPf OF fIX1Uf2F OR ITf.M N0. TYP[ OF FIXTURE OR ITEM <br /> __ Toilet __ A/C - air handling units <br /> _ Bathtub _ Forced air sys:ems <br /> _ Lavatory(wash basin) _ _ Gas piping <br /> __ _ Shower Waterheater ---�� <br /> -- = Kitchen sink& disposal _ __ Gas fiieplace �( \ <br /> Dishwasher Gas range � \ / <br /> C�otlies w.�sher Uotli�s dryer y <br /> __ _ Waterheater Rangehood <br /> _ Sink(serviceA�admop/etc.) _ __ E xhausNan j� <br /> __ _ Backflow preventer _ _ Heat pump /i' <br /> Urinal Unit heatei <br /> _ DrinkingFountain __ _ Boiler <br /> _ Floordrain _ Refrigeration <br /> __ Grease vap _ Woodstove <br /> - -- <br /> ---- <br /> Roofdrains ___ . Other__________________ <br /> ---- Other------------- <br /> U1V OF CVCR[TT LOCAL SALCS TA% CODE IS 3105 <br /> I he�eby ceriufy that I have read and examined this applicauor and know the same ro be true and correcl All pr�visions of laws and <br /> ordinaces goveming this rype o(work will be complied witli wheti,er speci(ied herein or noL 1 hc granting o(a permit does not presume <br /> to give authoriry to violate or cancel the prcvision of any other state or lucal law mgulating construc6on or the performance of <br /> consiruction. Tiiat I am authorized by the owner of ihis property io perfnim the work for which applicaoon is made and I comply with ihe <br /> 5 ontracloisL�iw18.:JRCWand29G.20D1NAC. <br /> i i� /-- �o//i/l`� <br /> Si�r i e 0 �ed�ontraUodAuthorizedAgent Dat <br /> '1.� <br />