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P�.ZNlIT APPLICATIG�J <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810— FAX 425-257-8857 —www.everettwa.org G `�`O� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBI7' & CREDIT CARDS ARE !JOT ACCEPTED <br /> SITE ADDRESS PARCEL TAX I.D.# P RMIT# � <br /> 10217 19th Ave SE Suite 202 �� ��lD <br /> LEGA LOT NO. BLOCK TRACI' <br /> DESC. <br /> OWNER ADDRESS CITYIZIP PHONE <br /> TENANi�AME CONTACT FOR PERMIT PHONE <br /> Dr Charles Kim Mark E Holey 425.481.7669 <br /> CONTRACTOR ADDRESS CITY/ZIP � PHONE <br /> Crown Fire Prot?ction, Inc. 4932 W. Interurban Blvd Bothell , WA 98012 425.481.7669 <br /> CONTR.LICENSE# <br /> CROWP�FP044LL <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> Coimnercial eiectric Gas oiner $2�000.00 <br /> WORK DESCRIPTION <br /> Add 21 sprinkler heads <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet A/C—air handling units <br /> Balhtub Forced air systems <br /> Lavalory(wash basin) Gas piping <br /> Shower Water healer <br /> Kitchen sink 8 disposal Gas fireplace <br /> Dishwasher Gasrange <br /> Clolhes washer Clothes dryer <br /> _ Laundry tray Range hood <br /> Sink(service/bar/mop/etc.) Exhausl fan <br /> Backilow preventer _ Heat pump <br /> Urinal Unit heater <br /> Drinking Foun!ain Boiler <br /> Floor drain Refrigeretion <br /> Grease lrap Woodstove <br /> Roof drains Olher <br /> Other <br /> CITY CF EVERE?T LOCAL SALES TAX CODE IS J105 <br /> iI hereby ceritify tnat I have read and examined this applicalion and know lhe same to be lrue and correct. All provisions of laws and <br /> ordinaces governing this type of work will be complied wilh whether specified herein or not.The granling of a permit does not presume <br /> lo give aulhority to violate or cancel lhe provision of any olher state or loca!law regulaling construclion or the performarice of <br /> construction.That I am aulhorized by the owner of this roperty to per(orm the work for which applicalion is made and I comply wilh the <br /> State ontractors Law 18 2 RCW and 296.200 WAC. <br /> � <br /> Sig at re of OwnedContrac odAuthonzed Ayent ate <br />