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P��`RMIT APPLICATIt�N <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 <br />10105 MONTANA RD <br />LEGA LOT N0. <br />DESC. <br />OWNER <br />LAKELANDHOMES <br />TENANTNAME <br />CONTRACTOR <br />BLOCK <br />��I�S����L�UMBING INC. <br />RO-F3I-NP-"272C2 <br />USE OF BUILDING <br />WORK DESCRIPTION <br />PARCEL TAX I.D. # <br />TRACT <br />CONTACT FOR PERMIT <br />PHONE <br />KEN ROBINSUN-ELMSLIE (360) 403-7462 <br />A�DRESS CITY2IP PHONE <br />29330 124TH AVE N.E. ARLINGTON 98223 (360)403-7462 <br />INSTALL FIRE SPRINKI.GR SYSTBM IN NEW SPR <br />N0. I TYPE OF FI%TURE OR ITEM <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Ciothes washer <br />Laundry tray <br />Sink (service/badmopletcJ <br />Backflow prevenler <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Olher <br />HEATSOURCE <br />Eiectric Gas Other <br />i� <br />CONTRACT PRICE OF WORK <br />$3000 <br />N0. � TYPE OF FIXTURE OR ITEM <br />A/C — air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Ciothes dryer <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiier <br />Refrigeration <br />Woodstove <br />Olher <br />SPRINRL[dR HEADS <br />G!TY OF EVERETT LOCAL SALES 7AX CODE IS 3105 <br />I hereby ceriti(y that I have read and examinec' ihis application and know the same to be true and corcect. All provisions of laws and <br />ordinaces governing this type of work will be c�mplied with whether specified herein or not. The granting of a permit does not presume <br />to give authonty to violate or cancel the prov�sion of any other state or local law regulaGng construc6on or the perfortnance of <br />construction. That I am authorized by the ovmer of this property to perform the work for which applicallon is made and I comply with the <br />State Contractors Law 1827 RCW ans1,296?00 WAC. <br />1I1 <br />