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PERMIT APPLICATI�ON ` <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 TO 4 PM - <br /> SITE ADDRES �� ���� PARCEL TAX I.D.# PERMIT# <br /> 3003 West Casi o Rd. Building ' _��a <br /> LEGA LOT NO. BLOCK TRACT OR SUBDIVISION# <br /> DESC. <br /> OWNER ADDRESS CITY/21P PHONE <br /> Boeing Ca PO Box 3707 Seattle 98207 425.876-2594 <br /> TENANT NAME CONTACT FOR PERMIT PHONE 425.876-2594 <br /> Boeing Ca I L20118t'd AStemb0l'Skl E-MAIL leonard.astemborski@boeing.com _ <br /> CONTRACTOR ADDRESS CITY/ZIP PHONE <br /> TBD <br /> CONTR.LICENSE# <br /> USE OFBUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> MFG �Electric�Ga�l Other: $ �� ��' <br /> WORK DESCRIPTION <br /> Structural upgrade of upper deck for equipment <br /> PLUMBING 'MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM N0. 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&disposal . Gas fireplace <br /> Dishwasher Gas range <br /> Clothes washer Clothes dryer <br /> Water heater Range hood <br /> Sink(service/bar/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 3105 <br /> I hereby ceritify that I have read and examined this application and know the 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 authority to violate or cancel the 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 Contractors Law 18.27 RCW and 296.200 WAC. <br /> Leonard Astemborski 8/20/2012 <br /> Signature of Owner/Contractor/Authorized Agent Date � / <br /> � L <br /> � <br /> f <br />