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y . <br /> � � <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 96201 <br /> 425-257-8810—FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM f o -a 6� D,6 <br /> SITE ADDRESSa841 GLGN\VOOD AVG PARCEL TA7(�.D.K PERMIT�I / <br /> IC (.v/o - 1 `i <br /> LEGAL LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER ADDRESS CITYZP PHONE <br /> V LAD CONSTRUCTION <br /> TENANTNAME I CONTACTFORPERMIT PHONE <br /> KGN ROBINSON-GLMSLIE (360)403-74G2 <br /> O�R�B'PF�QFJMBING INC. 293A89��i AVG N.E. ARLINFV�C��Q8223 PHON�60)403-7462 <br /> RO-DI-NP-"272C2 <br /> CONTR.LICENSE M <br /> USE OF BUILDING I — HEAT SOURCE I CONTRACT PRICE OF WORK <br /> INGLBPAMII.YRGSIDENCE Electric Gas_Olher SSd30 <br /> WORK DESCRIPTION <br /> I S'PALL FIRL SPRINKLI:R SYSTL'M IN NGW SPR <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet _ NC—air handling units <br /> Bathtub _ Forced air syslems <br /> Lavatory(wash basin) _ Gas piping <br /> Shower _ Nlaler heater <br /> Kitchen sink&disposal _ Gas fireplace <br /> �ishwasher _ Gasrange <br /> Clothes washer _ Cbthes dryer <br /> Laundry lray _ Range hood <br /> Sink(service/barlmopletc.) _ Exhausl fan <br /> Backflow preventer _ Heat pump <br /> Urinal _ Unit heater <br /> _ Drinking Fountain _ Boiler <br /> Floor drain _ Refrigeration <br /> Grease lrap _ Nloodstove <br /> Roof drains Other <br /> OlhBf 39.I'It11F.1 I R IIIEAUS <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ceritiy that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br /> ordinaces goveming this lype of work will be wmplied with whether specified herein or noL The granting o(a pertnit dces not presume <br /> to give authority to violate or cancel the provision of any other state or Iocai law regulat:ng construction or the perfortnance of <br /> conslruclion.That 1 am aulhorized by lhe owner of this property to perfortn lhe work for which application is made and I comply with the <br /> State C i ntractor�aw 1827 R W and 296200 WAC. <br /> /��2� �,)1� � <br /> Signa re of OwnerlCon�actorlAuthonzetl Agent Da�— ( <br /> Z <br />