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. PERlVIIT APPLICATI4N <br /> CiTY OF EVERETT PERMIT SEi2VICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810— FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS AkE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEP7ED <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT# <br /> F a � � u��' !� <br /> LEGAL LOT NO. BLOCK Ti�ACT <br /> DESC. <br /> i OWNER ADDRESS CINIZIP PHONE <br /> Pan Am�rican lnc. 1020 SE 6verett Mall Way, Everett, WA 98208 <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> P�nvrnn r_�� ar����., Chrvstine Harvey 4?5-917-210� <br /> �or,TruoroR lnsignia Sign Inc. ADDRESS CIN21P PHONE <br /> CONTR.LICENSE# <br /> INSIGSI062QZ p0 �OX 2$49 Rentan, l=:A 425-917-Z109 <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> Chevron Gas Station —E�e""� —cas—o`he� S2000.00 <br /> WORK DESCRIPTION <br /> Remove existi�g Chevron signa�e 8 replace with new Chev:on Image Refresh/Extra <br /> Mi[e signage. <br /> PLUMBING MECHANICAL <br /> ryp. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet A/C—air handling units <br /> Bathtub Forced air systems <br /> Lavalory(wash basin) _ Gas piping <br /> Shower Water heater <br /> Kitchen sink&disposal _ Gas fireplace <br /> Dishwasher Gas range <br /> Clothes washer Clolhes dryer <br /> Laundry tray _ Rai�ge hood � <br /> Sink (service/bar/rnop/etcJ _ Exhsust tan <br /> Backflow preventer _ Heat pump <br /> Urina I Unit healer <br /> Drinki ng Fountain _Boiler <br /> Floor drain Refrigeration <br /> Grease trap _ Woodstove <br /> i Roof drains _ Olher <br /> I _ Other__ — <br /> � <br /> II CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> � I 1 hereby centify lhat I have read ar examined lhis application and know ihe same to be irue and correct. All provisions of laws and <br /> i ordinaces governing this type of work will be complied wilh whether specified herein or not.The granting of a permit does not presume <br /> ;o give authority to violate or rancel the provision of any othei state or local law regulating construction or lhe performance of <br /> conslruction.That I am authorized by the owner of this property to perform the work for which application is made and I comply with lhe <br /> i, Stale Contractors Law 18.27 RCW and 296.200 WAC. <br /> L�–�% —�-�--�-��v'� cr�.^ :%� 12/05/07 <br /> Signature o wnedContra to lAuthonzec ent Dale <br /> / Z <br />