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PFRMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, cVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 - www.eve�eC�wa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AIA TO 4 PM Q,...a.1 �-Qg <br /> SITE ADDRE55 PARCEL TAX I.D. k PERMIT a <br /> 2500 Hewrtt 004378G9300900 Spp�.g-co�� <br /> LEGAL LOT NO. BLOCK TRACi OR SUBDIVISION M <br /> oe s c� see attached <br /> OW��ER ADDRESS CIiY21P PHONE <br /> H &L PETEF�EN LLC �� 2325 79TH AVE SE---EVERETT,WA 98205-2210 <br /> TENANT NAN.E CONTACT FOR I`ERMIT PHONE 425-776-8835 <br /> Select Physical Therapy I Trecie Skiles newcermits�berrynem�signs.com <br /> e�nnnu <br /> CONTHACTOR ADUHE55 CITY2IP PHONE <br /> BERRY NEON SIGh SYSTEMS 7400 Hardeson Rd, Everett,WA 98203 425-776-8835 <br /> CONTH. LICENSE a BERRRYNC077CM <br /> USE OF BUILDING HEAT SOURCE I CONTRACT PRICE OF WORK <br /> COMMERICAL I $2750.00 <br /> ___ Electric ___Gas ___Other <br /> WORK DESCRIPTION <br /> INSTALL 4 separate receways with channel letters <br /> PLUMBING MECHANICAL <br /> Np, TYPE OF FI%TURE OR ITEM N0. TYPE OF FIXTUflE OR ITEM <br /> Toilet _ A/C -air handling units <br /> Bathtub __ Forced air systems <br /> Lavarory(wash basinl _ _ Gas piping <br /> Shower _ __ H'aterhearer <br /> Kitchen sink& disposal _ __ Gas fireplace <br /> Dishwasher _ __ Gas range <br /> Clothes washer _ __ Clothes dryer <br /> Waterhearer _ __ Nangehood <br /> Sink(serviceibarhnop/etc.) _ __ Exhaustfan <br /> BackFlow preventer ____ Heat pump <br /> Urinal _ _ Unithearer <br /> Drinking Fountai� _ _ Boiler <br /> Floordrain _ _ Re(rigeratlon <br /> Grease trap __ _ Woodstove <br /> - -- Roofdrains -- - Other------------------ <br /> - -- <br /> ---- Other------------- -- - ------------------- <br /> CITY Of [VERETT LOCAL SALES lAX CODE IS 3105 <br /> I hereby ceiiti(y that I have read and examined this applicauon and know the same ro be true and correcc All provisions of laws and <br /> ordinaces 9overning this rype o(work will be complied with whether specified herein or not The grantlng of a permit does not presume <br /> to give authoriry ro violate or cancel the provision nf any other state or bcal law regulating construcUon or the performance of <br /> construction.That I am authorized�y the owner of this properry to perform the work for which applicatlon is made and I comply with Ihe <br /> St ontraz rs Law 18.27 and 296.200 WAC. <br /> ��;����,�`�' �-/7 %� <br /> ig e Q�ne ontractor/Authorized Agent Dat <br /> �2 <br />