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PERMIT AP!'LICATION <br /> CITY OF EVERETT PERMIT SERVICES ! <br /> :l200 CEDAR STRFET, EVERETT, WA 98201 <br /> 425-257-8810 — FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARF".rrEpTED FROM 8 AM TO 4 PM 9-9''�� <br /> SITF ADDRESS BUILLING P. i PARCEL TAX I.D.# PER T# � p � <br /> 59�1 23rd DP..�7, EVERET?, 'dA 280902CO20700 I ��j�{�,e1 �U� <br /> LEGAL LOTNO. BLOCK TRn:T <br /> DESQ SEE A:TACHED <br /> OWNER ADC,RESS CITYIZJP PHONE <br /> SEAWAI COP,PORATE LOT 3C �LC 4332 Nc 97Tii ST SSATTLE 98115 206-525-2220 <br /> TENANT NAML CONTACT FOR PERMIT PHONE <br /> 4AROL➢ CHRISTSNSeN 206-325-2553 <br /> LAC BAKF.kY EQOIFMENT T.I. C/0 LANCa MUELLER ARCH?TEC'CS <br /> CONTRACTOR A�DRESS CITYIZIP PHONE <br /> t-0ERID?AN BUILDERS iivC. <br /> 1901 4TH AVENUE NORTH .SEATTLE, 98109 206-696-4880 <br /> CONTR.LICENSE# MERIDBS920DIK <br /> :S�/ �� z- <br /> USE OF BUILDIN'� HEAT SOURCE CONTRACT PRICE OF WORK <br /> OFFICE/WAREHUUSc I — g — 5151,COC.00 <br /> Electric Gas Other <br /> WORK DESCRIPTION <br /> CONSTRUCT NEW PRIV.ITE OF?ICEg, OPSf] OFF:CE S?AC� 5 RESTROCMS aITHIN ERZSTI\G SHELL BUILDING. SPACE <br /> WiLL BE USnD BY LHC BAKERY EQUIPMEIJT FOR OFFICE, WA4EHOGSE elNO DISTRi3UTZCt7 FOR <br /> COMIdERCI.IL 3ARERY cQUIPME.IT. <br /> I PLUMBING MECHANICAL <br /> Np, TYPE OF FIXTURE 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 /> Kitcl.en sink 8 disposal _ Gas fireplace <br /> Dishwasher �asrange <br /> Clothes washer _ Clothes dryer <br /> Laundry tray _ Range hood <br /> Sink(service/bar/mopletc.) _ Exhaust fan <br /> Backflow preventer _ Heat pump <br /> I Urinal _ Unit heater <br /> Drinking Fountain _ Boiler <br /> Floor drair, Refrigeration <br /> Grease trap _ Woodstove <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 application and know the same to be true and corred. All provisions of laws and <br /> ordinaces goveming this type of work will be ccmplied with whether sper,ified herein or noL The granting of a permit does not presume <br /> Ito yive authority lo violale or cancel Ihe provision of any other state or local law regulating construction 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�o tractors Law 1�7 R nd 296200 WAC. <br /> �� �.�� � 8/31/10 <br /> .,ignf�ture of O�lra or/Authonzed Agent Date <br /> iv <br />