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P {F-RMIT APPLICATICy <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 8 CREDIT CARDS ARE NOT ACCEPTED <br /> SITE ADDRESS PARCEL TAX I.D.# PERMIT# <br /> 1401 [7erri1l Creel: PRfiY 8-8470-000-061 6 067. �' � (}7-3 <br /> LEGA LOTNO. BLOCK TRACT <br /> DESC. 61 6 G2. See Att ched Le al <br /> NER A�DRESS CITY2IP PHONE �� — <br /> E15�—f 57-2i:.3 <br /> Fairfield a[]errill Creel: LP 5510 Iiorehouse Dr 9200 San Diego, CA 92121 <br /> TENANT NAME I CONTACT FOR PERMIT PHONE <br /> Rathy Orni, Triad Assoc A25-821-8448 <br /> CONTR4C70R Fairfield ADDRESS CITY2IP PHONE g58-457-212 <br /> 5510 t7orehouse Dr tt200 San Diego CA 92121 <br /> CONTR.LICENSE N <br /> EEDEYL*0?.2LD exp. 1/9/06 Localg (425) 640-9292 <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> ❑/1 <br /> N/11 _Eleclric _�as_Other <br /> WORK DESCRIPTION � L W R __ �� <br /> �'� � - / „ H i G �i-t�- = I � ' S /�'���-(' <br /> /.� i �u� �U.�.��C . ��R �� _ I�•5 ' �o �- <br /> PLU BING MECHANICAL <br /> NO. TYPE OF FIX7LRE OR ITEM NO. TYPE OF FUCTURE OR ITEM <br /> _ Tollet /vC—air handling unils <br /> _ Bathtub Forced air systems <br /> _ Lavatory(wash basin) Gas piping <br /> _ Shower Waterheater � <br /> _ Kilchen sink 8 disposal Gas fire lace <br /> _ Dishwasher ���� — P N/A <br /> Gas range � , . <br /> _ Cbthes washer Clothes dryer �� 11 <br /> Laundry tray Range hood �V <br /> ,_ Sink(service/bar/mop/etc.) Exhaust tan '/ <br /> _ Backflow preventer Heat pump ' <br /> _ Urinal Unil heater <br /> _ Drinking Fountain Boiler <br /> _ Floor drain Refrigeration <br /> _ Grease lrap Woodslove <br /> _ Roof drains Olher <br /> Other — <br /> CITY OF EVERETT LOCAL SALES TAX COOE IS J105 <br /> I hereby ceritify that I have read and examined this application and know the same lo be Irue and correct. All provisions of laws and <br /> Iordinaces govorning this type of work will be complied with whether specified herein or noL The granting of a permit does not presume <br /> to give authorily to violale or cancel the provision of any other state or local law regulating construction or the performance ot <br /> construction.That I am authorized by the owner of lhis property ro peAorm lhe work for which application is made and I comply wilh lhe <br /> Stale Conlractors Law 18.27 RCW and 296200 WAC. <br /> Sgnalure of OwnedContractor/Authonzed Agent Date � <br />