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�ERMIT APPLICATI�UN <br /> CITY OF EVERE�T PERIJIIT S � RVICES <br /> 3�00 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257 8857 - www.everettwa.org <br /> APPLICATIONS ARE ACCEP'(EDFROM8AMT04PM "��.,'� S —ID <br /> SITE ADDRE55 PARCEL TAX I.D. k PERMIT q <br /> 12728 Bothell Everett Hwy(19th) 28053000400100 � (��� <br /> �� rk"S.� ' <br /> LEGAL LOTNO. BLOCK TRACTORSUBDIVI5:0411 <br /> oesc. seeattached <br /> OWNER ADDRESS CITY2IP PHONE <br /> BUII.DERS INVESTMENT GROUP LLC �� 12728 BOTHELL EVERETT HWY---EVERETT,WA 98208 <br /> TENANTNAA1E CONTACTFORPERMIT PHONE 5 <br /> PNW Professional Center I iveeie�kiies��''�`'�'��s�c`� ya`'-3�q -�3 <br /> �-1:� k�t I E-MAIL newpermits@berryneonsigns.cam <br /> CONTRACTOR ADDflE55 UTY21P PHONE <br /> BERRY NEON SIGN SYSTEMS 7400 Hardeson Rd, Everett,WA 98203 425-776-8835 <br /> CONTR. LICENSE M BERRRYNC077CM <br /> USE OF BUILDING HEAT SOURCE CONTRACT PPICE OF WORK <br /> COMMERICAL ___ Electric ___Gas ___other ' � � Z/ �I �(J' <br /> WORK DESCRIPTION <br /> Add on to existing sign base,adding illuminated freestanding sign <br /> PLUNiBING MECHANICAL <br /> N0. TYP[ OF FI%TUR[ OR ITENi NO. TVPE OF FIXTURE OR ITEM <br /> __.,_ Toilet A/C - air handling units <br /> _ __ Bathmb T Forced air systems <br /> _ _ Lavdtory (wash basin) Gas piping <br /> 5 howe r W a ter hea te r <br /> _ _ Kitchen sink& disposal _ Gas fireplace <br /> _ _ Dishwasher __ Gas range <br /> __ _ Clothes washer __ Ucthes dryer <br /> __ _ Water heater _ Ranga hood <br /> _ Sink(serviceibadmop/etc.) _ Exhaustfan <br /> __ Back(lowpreventer _ Heatpump <br /> _ Urinal Unitheater <br /> _ Drinking Fountain Bciler <br /> ___ Ploordrain __ RefrigeraUon <br /> ___ , Grease trap ____ Woodsrove <br /> ___ Roo(drains ____ Other__________________ <br /> 1 Otlier <br /> CITY Of F.VFRETT LOCAL SALES TAX COD[ IS 3105 <br /> I hereby ceritify that I have read and examined this application and know the same to be true and correct All provisions of laws and <br /> ordinaces goveming Uiis rype of work will be complied with whether specified herein or not The granting o(a permit does not presume <br /> to give authority to violate or cance�the provision of any otlier state or local�aw regulahng conshucUon or the performance o( <br /> cons truciion. That I am authorized by the owner oF this properry ro per(orm lhe work for which applicauon is made and� comply with the <br /> �State ontractors Law 18.27 RCW and 296.200 WAC. <br /> �19�/� ����� l(� <br /> t r o OwneuConiracror/Authorized Agent Date <br /> I/� <br />