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i j <br /> PEF�MIT 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 T4 4 PM �j �al( ,. � <br /> SITE ADDRESS PARCEL TAX I.D.# P R T#, <br /> 10520 19th Ave SF. 00575200201801 (.> >' �,� <br /> LEGA LOT NO. BLOCK TflACT OR SUBDIVISION M <br /> oesc. l8 19 20 2 Silver I.ake Garden ir <br /> OWNER ADDRESS CITY2IP PHONE <br /> Coastal. Corrmunity Bank PO Rox 12220 Everett, WA 98206 (425) 258-5291 <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> G>astal C.�rtmunity Isank Cary Yarkinson (425) 252-2153 <br />, e�a�Rary@�aryparkinson.c m <br /> L'BATRS�fO �2 <br /> To be detettnined `\ - <br /> CONTR.LICENSE# � -J S <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> Of f i ces _Electric �Gas_Other $250,000 <br /> WORK DESCRIPTION <br /> Remodel of existing floor plan, conference room, ofEices and entry. <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF flXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet A/C—air handling units <br /> Bathtub Forced air systems <br /> Lavatory(wash basin) Gas piping <br /> Shower Water heater <br /> Kitchen sink 8 disposal Gas fireplace <br /> Dishwasher Gas range <br /> Clothes washer Clothes dryer <br /> Water healer Range hood <br /> Sink(service/badmop/etc.) Exhaust fan <br /> Back(low preventer � Heat pump <br /> Urinal Unit heater <br /> Drinking Fountain Boiler <br /> Floor drain Refrigeration <br /> Grease trap Woodstove <br /> Roo(drains Other <br /> Other <br /> CITV OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ceritify thal I have read and examined Ihis application and know Ihe same to be true and correct. All provisions of laws and <br /> ordinaces 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 authori�y to violate or cancel ihe provision of any other state or local law regulating construction or the performance of <br /> construction.That t auth rized by the owner o �his property to perform�he work for which application is made and I comply with the <br /> State Contr "ca tois}aw 18. R W and 296.200 AC. <br /> l; ,�.,;�, i,J , + �i' � 1 L . �_C�U c�' <br /> S atu of wn /C ntractodAuthonzed Agen Dale <br /> � �( � <br />