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Ft LERMIT APPLICATifON <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 PNI - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />SITE ADDRESS PARCEL TA)( I.D. # PtE�RMIT #�/ <br />1402 Everett Mall Way, #106— <br />LEGA LOT I;O. BLOCK TRACT <br />DESC. <br />OWNER ADDRESS CITY/ZIP PHONE <br />TENANT NAME <br />CONTACT FOR PERMIT PHONE <br />Just Sports <br />John Abel 425.481.7669 <br />CONTRACTOR ADDRESS CITY/ZIP I PHONE <br />Crown Fire Protection, Inc. 4932 W. Interurban Blvd. Bothell, WA 98012 425.481.7669 <br />CONTR. L'CENSE # <br />CROWNFP044LL <br />USE OF BUILDING <br />HEAT SOURCE <br />_ <br />CONTRACT PRICE OF WORK <br />Retail <br />I _ Electric _ Gas _ Other <br />$500.00 <br />WORK DESCRIPTION <br />Relocate 5 heads <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />NO. TYPE OF FIXTURE OR ITEM <br />_ <br />Toilet <br />_ <br />A/C — airhandlingunits <br />_ <br />Bathtub <br />_ <br />Forced air systems <br />_ <br />Lavatory (wash basin) <br />_ <br />Gas piping <br />Shower <br />Water heater <br />Kitchen sink & disposal <br />_ <br />Gas fireplace <br />Dishwasher <br />_ <br />Gas range <br />_ <br />Clothes washer <br />_ <br />Clothes dryer <br />Laundry tray <br />_ <br />Range hood <br />Sink (service/bar/mop/etc.) <br />Exhaust fan <br />_ <br />Backflov/ preven(er <br />Heat pump <br />_ <br />Urinal <br />Unit heater <br />_ <br />Drinking Fountain <br />Boiler <br />Floor drain <br />Refrigeration <br />_ <br />Grease trap <br />Woodstove <br />_ <br />Roof drains <br />Other <br />Other <br />CITY OF EVERETT LOCAL SALES TAX 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 />ordinates 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 C nlractors Law 18.27 RCW and 9�AC. <br />i <br />4.25.06 <br />Signature of Owner/Contractor/Authorized Agent Dale <br />1 <br />