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PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CcDAR STREET, EVERETT, WA 98201 <br />425-257-8's10 - FAX 425-257-d857 -www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 PM TO 4 PM <br />SITE ADDRESS PARCEL TAX I.D. N <br />�93'I �.Jest tdnrine View r. OOQ39�67901900 <br />LEGAL lOTNO. BLOCK TRACT <br />oesc. 19 of 70 679 d-00 _ <br />OWNER ADDRESS CITY2IP <br />Richr,rd Lapinski PO Dox 1978 �verett, 41A 9gz�6 <br />TENANTNAME <br />�Cat ?",edical <br />CONTRACTOR <br />5lilcox ConsCruction Inc <br />CONTR. LILENSE # <br />-C� <br />CONTACT FOR PERMIT PHONE <br />ldilcor Construction - Matt Lessard 425�-774-4185 <br />ADDRESS CITYIZ�P PHONE <br />2�4 - 5th Ave. Srnith �dmonds, ';JA 9807.0 425-774-41F5 <br />II � � � � • <br />USE OF BUILDING I HEAT SOURCE I CONTRACT PRICE OF WORK <br />Re tai 1 I _ Electnc K Gas _ Other I 2�� �, 562 <br />WORKDESCRIPTION The project will consist of the construction of a new Tenant Tmnrovem <br />includinr� i.he constivction of' interior non-lond bearin� partition walls. UI1Qaew ADA <br />comiiant; rest.rooms shall be installe� in accordance with the 2003 IAG and ANSI A117.1. <br />The t�erhanicr�l, Electric�_, �• P1umUint� shall Ue a part of this nroject. The T.I. will a <br />NO. I TYPE OF FIXTURE OR ITEM <br />Todet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Laundry tray <br />Sink (service/badmop/etc,) <br />Backtlow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Other <br />NO. I TYPE OF FI%TURE OR ITEM <br />A/C — air handling units <br />_ Forced air systems <br />Gas piping <br />Water healer <br />Gas fireplace <br />Gas range <br />Clathes dry �r <br />Range hood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Waodstave <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby cerdify that I have read and examined this application and know lhe same to be true and cortect. All provisions of laws and <br />ordinaces governing this type of work will be complied with whether specified herein or nol The granting ot a permit does not presume <br />to give authonty to violate or cancel the provision of any other state or local law regulating consWction or;he pertortnance of <br />construr,tion. That I m authorized by the owner of this property ro perform the work for which applicatlon is made and I comply with the <br />State Contractora� w 827 RCW and 296200 WAC. <br />/ .CQ�' - �/ 1^-5_2006 <br />Signat 0 ed(. mtractor/Aut nzetl Agent Date � IL <br />