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4- __" '_ ---- ___- <br /> I <br /> �'ERMIT APPLIC�'�TIO(V <br /> CITY OF EVERE7T PEF?MIT' aERVICES <br /> 3200 CGDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810— FAX 425-257-8857—www.everetlwa.org <br /> APPLICATIONS ARE ACCEPTED f ROM 8 AM TO 4 PM -DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> SITE AD�RESS� PARCEL TAX I.D.N PE IT# � <br /> 180041' Stmet osaziiui�nozou, ouszs�zm��unino, oo�zosnnuno z ��d'i�� <br /> LEGA LOT NO. BLOCK TRAC7 <br /> DESC. Sl'C Aft.11'I1Cl� <br /> OWNER � AD�RESS CfTYlLIP PHONE <br /> Vcrizon Northwcst Id00 G. Phillips 131vJ.,CAA22SG Pomona, CA 9U66 Ncal Lal3arr <br /> 909 �69-(371 <br /> TENANT NAME CONT4CT FOR PERMR PNONE <br /> Vcricon Northwcst Kord S Kurisu /Architect �325 870-0368 <br /> CONiRACTOR ADDR[SS CITY/ZIP PHONE <br /> CON7R.LICENSE ti <br /> USE OF RUILDING HEAT SOURCE CONTRAC7 PRICE OF WORK <br /> GeneralOffice _eiecvic X Gas_otnrr I $3�42,U00.00 <br /> WORK DESCRIPTICN <br /> Remudel aipprox. 22,000 s.(. of caistin�open office space for new gener�l uffice and training facility. <br /> Work will include new �vall partitions, fnishes and •:ssociated mechanical and electricul adjustmenls. <br /> PLU!JIBING MECHANICAL <br /> NO. TYP[OF FlXTURE OR ITEM NQ. TYPE OP FIXTURB OR REM <br /> Toile[ A/C—air handling units <br /> � Bathtub Forced aIr systems <br /> Lavatory(wash besin) Gas piping <br /> Shower Water heatar <br /> Kitchen sink&disposal Gas firepla�:e <br /> Dishwasher � Gas range <br /> Clothos washer � Ctolhes dryer <br /> Launtlry tray _ Ran90 hood <br /> T Sink(servicel6arlmopletc.) _ [xhaus[fan <br /> � Backtlow preventer _ I loat pump <br /> � Urinal Unll heator <br /> Drinking Fountafn Boiler <br /> Floor drain Refrlgoration <br /> Grease trap Woodstove <br /> Roo(d rains ����z� <br /> Olher <br /> CITY OF EVERETT LOCAL SALCS TAX CODE IS a105 <br /> l hereby ceri6fy tbat I have read and examined this application and know lhe same lo be true and correcL All provisions of laws and <br /> ordlnaces goveming lhis type of work will be complied wilh whether specifiod horein or not.The granling of a permit dces not presume <br /> to yive authonty to violate or cancel lhe provision ot any olher slate or bcal law regulating consWctlon or the performance of <br /> consw�Uon.7hat I am aulhurized by the owner of lhis property to perform the work(orwhich application Is made and 1 comply with tho <br /> State Conlradors Law 1t;.27 RCW and 296200 WAC. <br /> /�.�,�_ ^ _ f v <br /> Signature of Owner nVactorlAulhonzed Aqent Dale �/� � <br /> �. <br />