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PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 9820' <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org <br />APDLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM I - <br />SITE ADDRESS <br />PARCEL TAX I.D. # <br />PERMIT # <br />1205 SE EVERETT MALL WAY <br />28051800404100 <br />LEGAL LOT NO. <br />BLOCK <br />TRACT OR SUBDIVISION If <br />DESG See attached <br />OWNER ADDRESS CITY(L I PHONE <br />EVERETT MALL 01 LLC 1113440 VENTURA BLVD STE 200 - - - SHERMAN OAKS, CA 91423 <br />TENANT NAME <br />CONTACT FOR PERMIT PHONE 425-776-8835 <br />Any Lab Test Now <br />I Tracie Skiles rewpermits@berryneonsigns.com <br />E-MAIL <br />CONTRACTOR ADDRESS CITY/ZIP PI10NE <br />BERRY NEON SIGN SYSTEMS 7400 Hardeson Rd, Everett, WA 98203 425-776-8835 <br />CONTR.LICENSE# BERRRYNC077CM <br />USE OF BUILDING <br />HEAT SOURCE <br />PRICE OF WORK <br />COMMERi(-AL <br />_ Electric _ Gas __- Other <br />c�CONTRACT <br />L — <br />WORK DESCRIPTION <br />INSTALL 1 lit wall sign <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />NO. TYPE OF FIXTURE OR ITEM <br />_ Toilet <br />— <br />A/C - air handling units <br />_ Bathtub <br />Forced air systems <br />__ <br />Lavatory (wash basin) <br />Gas piping <br />Shower <br />Water heater <br />Kitchen sink & disposal <br />— <br />Gas fireplace <br />Dishwasher <br />Gas range <br />__ <br />Clothes washer <br />_ <br />Clothes dryer <br />Water heater <br />_ <br />Range hood <br />— Sink(service/bar/mop/etc.) <br />Exhaust fan <br />Backflowpreventer <br />_ <br />_ <br />Heatpump <br />Urinal <br />_ <br />Unit heater <br />Drinking Fountain <br />__ <br />Boiler <br />drain <br />_ <br />Refrigeration <br />_Floor <br />__ Grease trap <br />__ <br />Woodstove <br />Roof draIns <br />Other_ __ <br />_-- Other <br />----- <br />CITY OF EVERETT LOCAL SALES TA CODE IS 3105 <br />1 hereby ceritify that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br />ordinaces governing this type of work will be complied with whether specified herein or not The granting of a permit does not presume <br />to give authority to violate or cancel the provision of any other state or local law regulating construction or the performance of <br />construction. That I am authorized by the owner of this property to perform the work for which application is made and I comply with the <br />State Contractors Law 18 CW and 296.200 WAC./I ()J) <br />P'n'altu're'bf er/Contractor/Authorized Agent / ' gate / <br />( Z. <br />