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PEh�MIT A►PPLiCAT�ON <br /> CITY OF EVERETT PERM17 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 3 � �Z_ D� <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT# <br /> 1402 SE Everett Mall Ylay 28051800401801 iLV'J U 3- OrJ L� <br /> i <br /> LEGAL LOTNO. BLOCK TRACT <br /> DESC. <br /> OWNER qDDRESS CITYlZIP PHONE <br /> Steadfast Vi_llage Annex, LLC 4343 Von Karman Avenue Newport Beach, CA. 92C '.0 949-852-0700 <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> T J D]axx piane Hinton 360-651-7701 <br /> CONTRACTOR AD�RESS CITYlZIP PHONE <br /> Smith Pire Systems 3813 158th St. NE, Suite 1 Arlingtan, 19A. 98223 360-651-7701 <br /> CONTR.LICENSE# <br /> Sf•]ITN@'51360T <br /> USE OF BUILDING — HEAT SOURCE I CONTRACT PRICE OF WORK <br /> Retail Eleclric Gas Olher 557�896.00 <br /> WORK DESCRIPTION <br /> Install fire sprinkler system � 278 Heads ) <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR IT[:M NO. TYpE OF FIXTURE OR ITEM <br /> _ Toilel A/C-air handling unils <br /> _ Bathtub Forced air systems <br /> _ Lavatory(wash basin) Gas piping <br /> Shower Waler heater <br /> _ Kitchen sink 8 disposal Gas fireplace <br /> _ Dishwasher Gasrange <br /> _ Clolhes washer Clolhes dryer <br /> Waler heater Range hood <br /> Sink(service/badmop/etc.) Exhausl fan <br /> �, _ Backflow prevenler _ Heat pump <br /> Urinal Unit heater <br /> Drinkinc� Fountain Boiler <br /> _ Floor drain Re(rigeralion <br /> Grease trap Woodstove <br /> Roof drains Olher <br /> Other <br /> CIN OF EVERETT LOCAL SALES TAX COOE IS 3105 <br /> I hereby ceritify that I have read and examined this application and know Qie same to be true and currect. AII provisions of laws and <br /> ordinaces governing this type of work will be complied�aith whether specified harein or nol.l'he granting of a permit does not presume <br /> to give authorily to violate or cancel the provision of any other stale or local law regulatiny conslruction or the pedormonce ot <br /> consUur.tion.That I am authorized by the owner of this property to perform the work for which application is made and I compiy with the <br /> State Contractors Law 18.27 RCW and 296.200 WAC. <br /> � �i.._.avr� �, i,...�.t 3-9-07 <br /> Signalure of Owned ntractodAuthorized Agent Date <br /> I2 <br />