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PERMIT APPLICATIUN <br /> CIT`( OF EVERETT PERMIT SERVICES <br /> 32U0 CEDAR STREET, EVEftE'�T, WA 98201 <br /> 425-257-RS10 - FAX 425-257-885� - www.everettwa.org <br /> APPLICATIOI�S ARE ACCEPTEDFROMSAMT04PM � ,_.�5� .-�� <br /> SITE ADDRESS I Hy, ��u Sc PARCEL TAR I.D. k PERMIT tt <br /> 12728 BoY�eH-Ev�erc�tM-Iwy-Ea-9t#� 28053000400100 � ��$ - v0� <br /> LEGAL LOTNO. fiLOCK TRACTORSUBDIVISIONtl <br /> DESC. $eedLTBCIl2CI <br /> OWNER AUDRESS CITY2IP PhIONE <br /> BUILDERS INVESTMENT GROUP LLC �� 12728 BOTHELL EVERETT HWY--- EVERETT,WA 9820i3 <br /> TENANT NAME CONTACT FOR PERMIT PHONE 425-776-8835 <br /> UW Medicine/NW Hospital I Tracie Skiles newpermits@6erryneonsigns.com <br /> e-rnnu <br /> CONTftACTOR ADURF55 UTYlLIP PHONE <br /> BERRY NEON SIGN SYSTEMS 7400 Hardeson Rd, Everett,WA 98203 425-776-8835 <br /> coNTa.uceNse a BERRRYNC077CM <br /> USE OF BUILDING .j HEAT SOURCE CONTRACT PRICE OF WORK <br /> COMMERIC".L Gf c� �'��'"���� ___ Electric ___Gas ___Other � � �jC10`�— <br /> WORK DESCRIPT N�� � ��( 1�C��. r�1 � ] � <br /> �/ �1 <br /> PLUMBING MECHANICAL <br /> ryp, TYPE OF FI%TURE OR ITEM NO. TYPE Of FI%TURE OR ITEM <br /> r <br /> � Toilet A/C - air handling units <br /> r Bathwb _ __ forced air zystems <br /> __ Lavarory(wash basiN ___ Gas piping I <br /> Showei ___ Waterheater <br /> j� Kitchen sink& disposal ___ Gas freplace <br /> ,i Dishwasher ____ Gas range <br /> � Uothet, washer ____ ❑othes dryer <br /> -i-- Range hood <br /> I Warerheater Exhaustfan <br /> ,� Sink (zervice/badmop/etc.) --- <br /> BackFlow preventer ___ Heat pump <br /> � Urinal ____ Unithearer <br /> �-- Boiler <br /> I Drinkiny Fountain --- <br /> � Floordrain ____ Refiigeration <br /> r Grease tnp ____ 4Voodsrove <br /> --- Roo(drains----------- I ---- Other_--_----------- <br /> 5--- <br /> o�i,��------------ --- --------------- <br /> CRY OF EV[RETT LOCAL SALE TAR CODE IS 3105 <br /> I herehy ceriti(y that 1 have read and examined �his application and know the same ro be true and correct All provisions of laws and <br /> ordinacr.s govemin9 this rype of work will be coinplied wiih whether specified herein or not TI�� granting of a permit does no[presume <br /> to 9ive authoriry to violate or cancel the provision of any other state or bcal law re9ulaUng construction or[he performance of <br /> construction. That I am authorized by the owner o(lhis properry to per(orm lhe work(or which application is made and I comply with the <br /> State ConVxtors Law 78.27 RCW and 296.200 WAC. <br /> i � �, � 7��/ � <br /> S ign wr of Owne�ontractor/Authorized Ayent ate \ �� <br />