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PEHMI� APPLICATIO� . �=� � � i����,,: <br /> CITY OF EVERETT PERMIT SERVICES���� �,�� �_ .;; <br /> 3200 CEDAR STREET, EVERETT, V�1.4 98201 <br /> 425-257-8810 - FAX 425-257-8857 --� � <br /> � , <br /> �1 <br /> SITE ADDRESS PARCEL TAX I.D. � PEFMIT; <br /> 1300 41st St. , Everett � `�l 7�� <br /> �' � <br /> LEGA LOT�lO. BLOCK TRACT <br /> oesc. See Attac ed Plans (• heet A-1 ) ' <br /> OWNER ADDFESS ZIP PHONE � <br /> Verizon Communictions, PO Box 1003, Everett, WA 98206 <br /> TENANTNAME CONTACTNAME PHONE <br /> verizon communications ������ ��,� ���, y��_����� <br /> CONTRACTOR ADDRESS ZIP CONTR. UCENSE d <br /> Johansen Mechanical, Inc. PO Box 1768, Woodinville 98072 JOHANMI173PK <br /> PHONE <br /> 425-4�l1-2266 <br /> PqOPOSED USE OF BUILDING BUilding � Mechanical Aadiiion I HEAT SOURCE <br /> PERMIT R Corrhination Plumbing WORK �J Alteralion � Electnc I <br /> TYPE D Demolilion Sign 7vFE D rJew ces ' <br /> U Sprinkler U RepainldainL Giher , <br /> CONTRACT PRICE OF WORK p Q� CITY OF EVERETT LOCAL SALES TAX CO�E IS 3105 li <br /> � �0� �d � <br /> WORK DESCAIPTION I� <br /> HVAC Modifications per drawings. I <br /> I <br /> PLUMBING MECHANICAL �ii <br /> NO. TYPE OF FIXTURE OR IT[M NO. TYPE OF FIXTUfiE OR ITEhi I <br /> WATER CLOSET A/C –A/HANDLING UNITS I <br /> BATHTUB _ FORCED AIR SYSTEMS I, <br /> LAVATORY (WASH BASIN) _ HEAT PUfviP <br /> SHOWER UNIT HEATERS <br /> KITCHEN SINK 3 DISPOSAL CLOTHES DFYER <br /> DISH4VASHE� RANGE HOOD � <br /> LAUNDRY TR��Y WATER HEATER <br /> CLOTHES WASHER METAL FIREPLACEBTOVE <br />� = URINAL = FIRE°LACE INSERT <br /> DRINK!NG FOUNTAIN GAS FIRE?LACE <br /> FLOOR DRAIN GAS RANGE <br />� _ BACKFLOW PREVENTER GAS PIPING <br /> _ SINK (SERVICE/BARiMOP!ETC.1 � EXHAUST FAN <br /> OTHER � OTHER_Pan Coil Units <br /> — � VAV Boxes <br /> — i <br /> I HEFEBY CcRITIF'f'HAT 1 HAVE REA�AND EXA1dWED THIS APPLICATION ANL� KNOW THE SAtv1E TO BE TRUE AND CORREGT. ALL <br /> PIiOVIS10N5 OF L.1'NS AND ORIDINACES GOVERNING THIS T'!PE CF`NORK'�YILL 6E GOF.-0FUED'.VITH LVHETHER SFECIFIED HEREIN OF <br /> NOT. 7HE GRdfITING OF A PEP.MIT DOES NOT PRESUME TO GIVE AUTHORITV TO VIOL4TE OF CAI9CEL.THE PRGVISION GF ANY OTHER �. <br /> STAT�CR LOCAL L;1W REGUL4TING CONSTRUCTION OF THE PERFOFh1ANCE OF CONSTRUCTION. THAT I,1M dUTHORIZED 6Y THE <br /> C���n�FR CF THIS PRCPERN TO PERFCRM THE'I✓ORK FOR WHICH APFLICATION IS PdADE AND I COh1PlY WITH THE STATE <br /> CI 7AGTOFS�L.1W �827 FGW AN�296.2C0 WAG _ <br /> . ., � � �r �� � �-. <br /> , ) �' *-t i ;� � �' � <br /> Siynawre oi OwneoContractor/Authonzed Agent Dale , <br /> _ ___ . _ - . _------- — . <br /> , _ l <br /> �,� <br />