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� i <br /> PER�VIIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 – FAX 425-257-8857–www.everetlwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM ` _�/ —%(� <br /> SITE ADDRESS BUILDING B pARCEL TAX I.D.# PERd�IT# <br /> SGO1 23rd DR.W, EVERETT, WA 290402Q020700 �r, �/ <br /> LEGAL LOTNO. BLOCK TRACT <br /> DESC. SEE ATTACHED <br /> OWNER ADDRESS CINZP PHONE <br /> ScJiWaY CORPORATE LOT 3C LLC 4932 NE 97TH 5? 3EdTTLE 98115 206-525-2220 <br /> TENANT NAME CONTACT FOR PERMIT PHONE <br /> HAROLD CNRISTENSEN <br /> RORAL/IdE'PRO AMBULANCE SERVICE C/0 LANCE MUELLER ARCHITECTS Z06-325-2553 <br /> CONTRACTOR „^ . ' � �� \ / /�DRESS CITYRJP PHONE <br /> V 1�.4J1/�A J o� <br /> CONTR.LICENSE p <br /> USE OF BUILDING I — HEAT SOURCE CONTRACT PRICE OF WORK <br /> OFFICE/MAINTENANCE � $874,000.00 <br /> Eledric Gas_Other <br /> WORK DESCRIPTION <br /> CONSTRUCT NcW OrFICE SPACE WITHIN EXiSTING SHELL BUILDING. SPACE WILL BE [75ED FOR RURF.I,/MFTR OFFICE, <br /> COMtdONICAT70N AND MAINTENACE ACTIVITIeRS. WORK WILL INCLU➢E A DEDIISIMG WALL, OFFICE 7PACE, RESTROOMS <br /> AND OPEN AREA WITHIN WAP.EHOUSE SPACF. FOR LiGHT MAINTENANC�. <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FI%TURE OR ITEM <br /> Toilel A/C–air handling unils <br /> Bathtub Forced air systems <br /> Lavatory(wash basin) Gas piping <br /> Shower Water heater <br /> Kitchen sink&disposal Gas fireplace <br /> Dishwasher Gas range <br /> Clothes washer Clothes dryer <br /> Laundry tray Range hood <br /> Sink(service/bar/r•ip!etc.) Exhaust fan <br /> Backflow preve;:'er Heatpump <br /> Urinal Unit heater <br /> Drinking Fountain Boiler <br /> Floor drain Refrigeration <br /> Grease trap Woodsiove <br /> Roof drains Other <br /> Other <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ceritify that I have read and examined this applicalion and know lhe same to be true and cortect. All provisions of laws and <br /> nrdinaces governing this type of work will be complied with whether specifiaC herein or not.The granting of a pertnit does not presume <br /> to give authority to violate or cancel the provision of any other state or!ocal law regulating construdion or the performance of <br /> construction. That I am authorized by the owner of this property to perform the work for which application is made and I comply with the <br /> State C tractors Law 8. W and 296.200 WAC. <br /> 12/14/04 �� <br /> gnature of Owner/Co ra or/Authorized Agent Dale I/ <br />