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10025 19TH AVE SE LAKESIDE ENDODONTICS 2017-07-13
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10025 19TH AVE SE LAKESIDE ENDODONTICS 2017-07-13
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Last modified
7/13/2017 7:36:58 AM
Creation date
7/13/2017 7:36:55 AM
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Address Document
Street Name
19TH AVE SE
Street Number
10025
Tenant Name
LAKESIDE ENDODONTICS
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f <br /> � <br /> PERMIT �►PPLICATION ---� <br /> CITY OF EVERETT PERMIT SERVIGES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810— FAX 425-257-8857—wv��v.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM / '} .- 9 _/(� <br /> i <br /> ' SITE ADDRESS s � 5u�.��2oZ � PARCEL TAX I.D.q PERMIT# <br /> bU2 V¢rch HIVCwh- �1f3Z� 01.� � �0 �ZO� 0� 2 �� <br /> LEGAL LOT NO. BLOCK TRACT OR SUBDIVISION# <br /> DESC. <br /> O NER ��he� Lt��'.D� ADDRESS CITY/ZIP PHONE <br /> fT l i o0�5 �q�^ M�S� v� �u� Nzs 33-r-� <br /> TENANT AfJ�E. [' CONTACT FOR PERMIT PHONE Z.rj •Z4��-USF�3 <br /> ��- ,�Yl�h �'�n' ����Y�°� /1� � , /� <br /> �4C�S[(�{ '1lbFX`!J'TiC� SR`�CN lJ-IT�-T£I� E-MAIL l(�SJI�&�'11..�JU11(�.CD <br /> Z`6FJ�RA TOR ADDRESS CITYI P E <br /> �y1f10Vq-F\VZ COVinf�2-� �,LS-lect�S l"2`� Snchnvtn i`h R�- Snd�e�u.�Slnl`Zg�'lb `/'�-�- <br /> ONTR.LICENSE# /D/n//� <br /> ►nnovc� 9r�1'�'�1 jl <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> ���`C _ _Electric�Gas_Other � I I(��D•�`� <br /> WORK DESCRIPTION '"�j.�11 �� ��.,b-FpP Uy11� �d��o� $ �Uy�S <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet AIC—air handling units <br /> Balhtub Forced air systems <br /> Lavatory(wash basin) � Gas piping <br /> Shower Water heater <br /> Kitchen sink&disposal _ Gas fireplace <br /> Dishwasher Gasrange <br /> Clo�hes washer Clolhes dryer <br /> Water hea�er Range hood <br /> Sink (servicelbar/mop/etc.) � Exhaust fan <br /> BackFlow preventer Heat pump <br /> = Urinal Unit heater � <br /> _ Drinking Fountain Boiler <br /> Floor drain Refrigeration <br /> Grease trap _ Woodstove <br /> Roof drains Other <br /> Other <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br /> I hereby certify ihal �have read and examined lhis applica�ion and know lhe same to be true and correct. AII provisions oi laws and <br /> ordinances goveming ihis type of work will be complied with whelher specifed herein or not.The granling of a permit does not presume <br /> lo give authority te violate or cancel the provision of any other s�ate or local law regulating conslruction or the performance of <br /> construction. That I am authorized by the owner of this property to periorm the work for which application is made and I comply with ihe <br /> Slate Contraclor w 18.2 CW and 296.200 WAC. <br /> '�� '�^ �p' !0 <br /> Signature of wnedContractoAAuthorized Agent Dale � <br /> Z <br />
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