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(55 u.v �� � /� �� -f>/,/ <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES (�',�u�� <br /> 3200 CEDAR STREET, EVERETT,WA 98201 O� — DO� <br /> 425-257-8810-FAX 425-257-8857-www.everettwa.org �� <br /> APPUCATIONS ARE ACCEPTED FROM 8 NM TO 4 PM <br /> SITE ADDRESS PARCEL TAX I.D.t "PERMIT X � <br /> 11533 Air rt Road Everett WA 982 8 00537900005300 ���� ��� <br /> LE LOTNO. BLOCK TRACT <br /> �Esc. 53 Paine Field Addition <br /> OWNER ADDRESS CITVZP PHONE <br /> The Mietzner Group 18913 Bothell-Everett Hwy. , Bothell,WA 98012 (425)482-9110 <br /> TENANTNAME I ��1N_T����P��IT�,CIl1LeCtS PHONE <br /> Y <br /> Tenant Lease TBD (Shell permit) Ryan Ellinghaus (425) 252-2153 <br /> CONTRACTOR ADDRESS CITY2IP �PHONE ' <br /> The Mietzner Group Same as Above <br /> CONTR.LICENSE�I <br /> USE OF BUILDING HEAT SOURCE I CONTRACT PRICE OF WORK <br /> OEfice & Retail I _Electric X Gas_Other <br /> WORK DESCRIPTION <br /> Construction of new 3-story Bldg. for office and retail use, parking lots and under- <br /> ground storm system. See attached narrative for compl��e details. <br /> PLUMBING MECHANICl.L <br /> NO. TYPE OF fOCTURE OR ITEM NO. TYPE OF Fl)CTURE OR ITEM <br /> Toilet AIC—air handling units <br /> Bathtub Forced air systems <br /> _ Lavatory(wash basin) _ Gas piping <br /> Shower Water heater <br /> IGtchen sink 8 disposal _ Gas fireplace <br /> Dishwasher Gas range <br /> Clothes washer Clothes dryer <br /> Laundry tray _ Range hood . <br /> Sink(servicelbar/mop/etc.) _ Exhaust fan <br /> Badcflow preventer _ Heat pump . <br /> Urinal Unit heater <br /> Drinking fountain � _ Boiler <br /> Floor drain Refrigeration <br /> �Grease trap . _ Woods�°`re <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. Afl provisions of lews arM <br /> ordinaces governing this type of work will be complied wiM whether specified herein or not TF�e graMing of a pertnit dces not presume <br /> to give authoriry to viola?e or caocel the provision of any oNer state or local law regulatin{,consWction or the performance of <br /> consVudion.That I am authorized by the owner of this property to perform the vrork for which application is made and I comply wiM the <br /> State ConVactors Law 18.27 RCW and 296.200 WAC. <br /> G/I�/��5� <br /> Signature of Owner/Contractor/Authonzed Agent � �/L <br />