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PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS <br />PARCEL TAX I.D. P <br />28051800402600 <br />PERMIT # <br />S(0 -U <br />950219th Ave SE <br />C D <br />LEGAL LOT NO. <br />BLOCK <br />TRACT OR SUBDIVISION # <br />DESC.1 seeattached <br />OWNER ADDRESS CITY/ZIP PHONE <br />JOHNSON R A FAMILY PTNRS 1110511 19TH AVE SE STE C - - - EVERETT, WA 98208 <br />TENANT NAME CONTACT FOR PERMIT PHONE 425-776-883.5 <br />Boys and Girls Club Tracie Skiles newpermits@berryneonsigns.com <br />EMAIL <br />CONTRACTOR ADDRESS CITY/ZIP PHONE <br />BERRY NEON SIGN SYSTEMS 7400 Hardeson Rd, Everett, WA 98203 425-776-8835 <br />CONTR. LICENSE N BERRRYNC077CM <br />USE OF BUILDING <br />HEAT SOURCE <br />CONTRACT PRICE OF WORK <br />COMMERICAL I <br />___ Electric --_ Gas --- Outer <br />$2680 <br />WORK DESCRIPTION <br />INSTALL 1 lit wall sign and one non lit sign <br />PLUMBING <br />MECHANICAL <br />NO. TYPE Or FIX10RE OR ITEM <br />NO. TYPE OF FIXTURE OR ITEM <br />Toilet <br />A/C - air handling units <br />Bathtub <br />__ <br />A <br />Forced air systems <br />Lavatory (wash basin) <br />Gas piping <br />Shower <br />_— <br />Water heater <br />Kitchen sink & disposal <br />__ <br />Gas fireplace <br />Dishwasher <br />Gas range <br />Clothes washer <br />_— <br />-_ <br />Clothes dryer <br />Water heater <br />__ <br />Range hood <br />Sink (service/bar/mop/etc.) <br />_ _ <br />Exhaust fan <br />Backflow, preventer <br />__— <br />Heat pump <br />Urinal <br />__-_ <br />Unit heater <br />Drinking Fountain <br />____ <br />Boiler <br />Floor drain <br />__-_ <br />Refrigeration <br />Grease trap <br />____ <br />Woodstove <br />Roofdrains <br />_—_ <br />Other--_---___- <br />---- <br />Other------------- <br />--- <br />-- -- '_ <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 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 />ordinates governing this type of work will be complied with whether specified herein or not The granting of a permit does not presume <br />to give authority to violate or c.incel the provision of any other state or local law regulating construction or die performance of <br />con"r ctio Tha I n authorized by the owner of this property to perform the work for which application is made and I comply with the <br />5tate. a t w18.21RCW OOWAC. <br />51 nature of Owner/Contractor/Authorized Agent <br />g I/l <br />