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PLRMIT APPLICATI(IV <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 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />SITE ADDRESS <br />PARCEL TAX I.D. # <br />PERMIT # <br />305 SE Everett Mall Way, Suite 31 <br />Ko(0a4-oo3 <br />LEGA LOT NO. <br />BLOCK <br />TRACT <br />DESC. <br />OWNER ADDRESS CITY/ZIP PHONE <br />TENANT NAME <br />CONTACT FOR PERMIT PHONE <br />Round Table Pizza <br />John Abel 425.481.7669 <br />CONTRACTOR ADDRESS CITYIZIP PHONE <br />Crown Fire Protection, Inc. 4932 W. Interurban Blvd. Bothell, WA 98012 425.481.7669 <br />CONTR. LICENSE # <br />CROWNFP044LL <br />USE OF BUILDING <br />HEAT SOURCE <br />CONTRACT PRICE OF WORK <br />Reta ; 1 <br />_ Electric _ Gas _ Other <br />$3 , 500.00 <br />WORK DESCRIPTION <br />Relocate 32 sprinkler heads Change out 5 sprinkler heads <br />Add 6 sprinkler heads <br />Add 1 dry pendant in freezer <br />PLUMBING <br />MECHANICAL <br />NO. I TYPE OF FIXTURE OR ITEM <br />NO. TYPE OF FIXTURE OR ITEM <br />_ <br />Toilot <br />_ <br />A/C — air handling units <br />_ <br />Bathtub <br />_ <br />Forced air systems <br />_ <br />Lavatory (wash basin) <br />_ <br />Gas piping <br />_ <br />Shower <br />Water heater <br />_ <br />Kitchen sink 8 disposal <br />Gas fireplace <br />_ <br />Dishwasher <br />Gas range <br />_ <br />Clothes washer <br />Clothes dryer <br />_ <br />Laundry tray <br />Range hood <br />_ <br />Sink (service/bar/mop/etc.) <br />Exhaust fan <br />_ <br />Backflow prevenler <br />Heat pump <br />_ <br />Urinal <br />Unit heater <br />_ <br />Drinking Fountain <br />Bailer <br />_ <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 cerilify 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 />St t�'Contraclors Law 18.27 RC an 216.200 WAC. <br />I <br />Sig1�ture of Owner/ ont acto /Authorized Agent Date �, <br />