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. � � <br /> I -� <br /> PERMIT 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 <br /> SITE ADDRESS PARCEL TAX I.D.p I ERMIT# <br /> 3726 Droadway, SuiCe 107 00437392500001 ��� � Z' � Q Q � <br /> LEGAL LOTNO. BLOCK TRACT <br /> DESC. 97.5 Division E <br /> OWNER AGDRESS CITYIZIP PHONE <br /> EvecetC Gateway Cen[er, LLC 2717 Aockefellex Ave. EveretC Y]A 98201 d�5-212-2.^.1C <br /> TENANT NAME I CONTACT FOR PERMITr PHONE !���; 7 J3 �'_ l U� <br /> Dro� Zone Em� Rim 1�1X a0b41Q . II� � �oe-aie-i000 <br /> LONTRACTOR Not selecCed yet ADDRESS CITYfZIP PHONE <br /> CONTR.LICENSE# �?j�� •� ����� <br /> ��� `/ <br /> USE Of•BUILDING H'cAT SOURCE CONTRACT PRICE OF WORK <br /> Medical oifice � re[ail �v EledfiC _Gas___Olhef SSO,UUO <br /> WORK DESCHIPTION <br /> Construc[ shipping and mail box store in recently cenetruc[ed building (first us� of tenanl s{�ace) . <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> _ Toilet ,qll plumbing ic exis[ing a�%—airhandlingcnits <br /> Balhtub Forced air sys�ems <br /> Lavatory(wash basin) Gas piping <br /> ShoWef N'aterhea�er All mechanical equipment <br /> _ Kitchen sink&disposal Gas fireplace <br /> Dishwasher Gasrange is exiscing <br /> Clolhes washer Clothes dryer <br /> Laundry tray Range hood <br /> Sink(service/bar/mop/etc.) Exhaust fan <br /> Backflow preventer _ Heat pump <br /> Urinal Urrt heater <br /> Drinkin�Fountain Boilar <br /> Floor drain Refngcralion <br /> Grease trap Woodslove <br /> Roof drains Other_ <br /> Other <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS�105 <br /> I hereby cenlify that I have read and examined this application and know the same to be W e and correcL All provisions of laws and <br /> ordinaces goveminG lhis type of work will be complieA with whelher specifed herein or not.The granling of a permit does not presume <br /> to give aulhority to violale or cancel the provision of any other stale or bcal law regulating construction or lhe performance of <br /> construction.That I am aulhorized by ihe owner of Ihis property lo pedorm the work for which applicalion is made and I comply wdh the <br /> Stale�onlractors Law 78.27 RCW and 29G.200 WAC. <br /> SignaWre o`OwnedContractorfAuthorized Agent Date �/z <br />