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�� =�� <br /> � � PERMIT APPLICATION <br /> Ci7Y OF EV�RE7T PERMIT SERVICES <br /> 3200 CEDAR .�,TREET, EVERETT, WA 98201 <br /> 425-257-8810- FAX 425-257-8857-www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �� 'Qn� <br /> SITE ADDRESS I PARCEL TAX I.D.# � PERMIT# <br /> 11014 19th Avenue SE I 28051900400400 _ <br /> LEGAL LOT NO. BLOCK T TRACT OR SUBQIVISION# . <br /> DESC. � <br /> OWNER ADDRESS CITY2IP PHONE <br /> BURNHAM ;'ATRICIA J PO BOX 1393---YAKIA� <br /> TENANT NAME CONTACT FOR PERMIT PHONE z53-926-2290 <br /> 24 Hour Fitness Chris�Vilscn E-Ma� <br /> �OT ACO AD S � �P <br /> Patriot Fire Protecfion, Inc. 2707 -70th Ave E, Tac� .na,WA 98424 (253)926-2290 <br /> coNrR.LICENSE a PATRIFP099CF <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> ❑ Electric � Gas ❑ Other S29,700 <br /> WORK DESCRIPTION <br /> add upright and pendent sprinklers as required for TI <br /> 28051900400400 <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF FI%TURE OR ITEM NO. TYPE OF FI%TURE OR ITEM <br /> Toilet 0.�C–air handling units <br /> Bathtub Forced air systems 1 <br /> _ Lavatory(wash basin) _ Gas piping � , <br /> Shower _ Water heater <br /> Kitchen sink&di�posal Gas tireplace 1 ,��' <br /> _ Dishwasher �' \ _ Gas range �\F�J <br /> Clol'ies washer � � Clothe>dryer � <br /> Water heater ���- _ Range hood v�4 <br /> Sink(service/badmop/e�c.) I _ Exhaust fan � <br /> _ Backflow preventer 1 _ Heat pump <br /> Urinal _ Unit healer <br /> _ Drinking Founlain q Boiler <br /> Floordrain � ,l� _ Refrigeration <br /> _ Grease trap � �( U` Woodstove <br /> ROofdrains �� � � �c; Other �llr�nlflrr5 <br /> Other_ � — <br /> -- — `�.� — <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 5105 <br /> I hereby ceritity that I have read and examined ihis application and know the same to be irue and correc�. All provisions of laws and <br /> ordinaces governing tliis type of vaork will be complied with whether specified herein or not.The granting of a permit does not presume <br /> to give authority to viol2te or cancel Ihe provision of any other state or local law regulating construction or the performance of <br /> construclion.That I am authorized by the owner of this property to perform the work for whicn application is made 3nd I comply with the <br /> State Contractors Law 18.27 RCW and 296.200 WAC. i � <br /> ; I � �: , � � � __---"--. � � :�'�,1, <br /> Signature ol' wnet/Goqti�icdAutl� ized Agent D9te �' <br /> 1`�1 \�.� Z <br />