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PERIIAIT APPLI�,ATION -_l <br /> CITY OF EVERETT PER'AIT SERVICES <br /> 3200 CEDAR STRFET, EVERETT, WA 98201 <br /> 425-257-8810— FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM y — (� � <br /> SITE ADC�RESS PARCEL TAX I.D.# PERMIT# <br /> 10217 19th Ave. SE, Sui.te 101 010209000101.00 � !� '��� <br /> LEGAL LOT N0. BLOCK TRACT Ofl SUBOIVISION tl <br /> DFSC. <br /> OWNER ADDRESS CITY/ZIP PHONE <br /> Yamasbichi LLC 10217 19th Ave. SG Everett, t4A. 58208 <br /> TENANT NAME I CONTACT FOR PERMIT PHONE <br /> 360-651-7701 <br /> Chase 8ank Di.ane Hinton E-MAILUhintonPSP1ITHFIRE.CO <br /> T T R �Z� <br /> Smith Pire Systems 4105 136th St. NE hiarysville, �4A, 9g271 360-651-7701 <br /> CONTR.LICEN3E N <br /> SPtITHFS1360T <br /> USE OF BUILDING — HEAT SOURCE I CONTRACT PRICE OF WORK <br /> :�ank Eleclric Gas_.Other $2020.00 <br /> WORK DESCRIPTION <br /> Relocate 17 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 /> Bathtub Forced air systems <br /> Lavatory(wash basin) _ Gas piping <br /> Shower Water heater <br /> _ Kitchen sink&disposal _ Gas fireplace <br /> Dishwasher Gasrange <br /> Clothes washer Clothes dryer <br /> Water heater Range hood <br /> Sink(serviceibarimop/etc.) _ Ezhaust fan <br /> Back(low pieventer _ Hea�pump <br /> Urinal Unit hea�er <br /> Drinking Fountain _ Boiler <br /> Floor drain Relrigeration <br /> Grease trap Woodstove <br /> Root drains Other <br /> Other <br /> CITY OF EVEREI7 LOCAL SALES TAX CO�E IS 3105 <br /> I hereby ceritify that I have read and examined this application and know Iha same to be true and correct. All provisions of laws and <br /> ordinaces goveming Uiis type of woik will be complied with whether speci(ied herein or nnL The aranting of a permit does not presume <br /> to give au�horiry 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�he owner of IIiis property to Ferform the work for which application is made and i comply�•:�th the <br /> Stale Contractor .La�v 18.27 RCW and 296.200 WAC. <br /> � <br /> �J ,�..� �` —�-1'..�--�'"- 4-6-09 <br /> S�gnaWre ol OwneriComractouAuthorized Agent Date <br />