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SITE ADDRESS <br />LOT NO. <br />PERMIT 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 TO 4 PM <br />BLOCK � TRACT <br />PARCEL TAX I.D. It <br />tQ-?R(�1&(iR ..2905 <br />Peter 6ralv Glacier Pr.operties 3409 ilclbueal-1 Ave Gverett (4251 <br />TENANTNAME I CONTACTFORPERMIT PNCNE <br />�1ty �UC�QI1SOf1 F�C�l1tC'CtS <br />To I3e Detetmin�i Rv� I�Lir�]� (a�5) 252-?.153 <br />CONTRACTOR ADDRESS CITY2IP PHONt <br />To I3e Detennineci <br />CONTR.UCENSEA <br />USE OF BUILDING <br />WORK DESCRIPTION <br />HEATSOURCE <br />_ Eleclric X Gas _ Other <br />CONTRACT PRICE OF WORK <br />Construction oE new tenant space includi.ng (2) restrooms and loading dock. Also new <br />sewer connection in Plclbuhal]. and 12 new angled parking stalls along McDougall Ave. <br />NO. � TYPE OF FI%TURE OR ITEM <br />Toilet <br />BalhWb <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Laundry Vay <br />Sink (servicelbar/mopletc.) <br />BackOow preventer <br />Urina� <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Olher <br />NO. I TYPE OF FIXTURE OR ITEM <br />A/C — air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clolhes dryer <br />Range hood <br />Exhaustfan <br />Neatpump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS �105 <br />1 hereby ceritify lhal I have read and examined this appiication and know lhe same to Le We and correcl. All provisions of laws and <br />ordinaces governing this type of work will be complied with whether specified herein or nol. The granting of a permit dces not presume <br />to give aulhority to violate or can I the provision of any other state or local law regulating construdion or the pertortnance of <br />constru�,t�� That I am autp6ifz�� lhe owner of this property to perform the work for which application is made and I wmply wilh lhe <br />State,L"on actors Law 18k� s na zss.2go��. <br />9/i2/o� <br />,. <br />/2 <br />; ` � 1 � i :� � ,� .%�� � <br />,�. , <br />