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PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3�00 CEDAR STREET, EVERETT WA 9II201 <br />425-257-8810 — FAX 425-257-8857 — ��wv+.everettwa.org <br />APPLfCATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDR CARDS ARE NOT ACCEPTED <br />SITE ADDRESS F'AP.CEL TAX I.D. A P�RMIT # <br />i <br />260d Rockcfellcr A�•c. 005G24GI1031U0 � � j�J J,j c/ <br />LEGAI LOTNO. I BLOCK I TRACT <br />DFSG SCC A��:iCIIC(I <br />OWNER ADDRESS CfTY2iP PHONE <br />Vcrizon ll2 L:ikc��icw ('am'on Road, CASOIVR, 'ihousand Oakti, CA 913G2 ,lim t3:iilc�• <br />gp5 372-GF <br />TENAN7NAME COiiTACT FOR PERMR PHONE <br />Vcrizon Norllnvest I I�ord S Kurisu / Arcli:tect 425 870-03G8 <br />CONTRACTOh <br />CONTR. LICENSE 1i <br />US-. OF [3UILDING <br />'Pcicphonc tiwitcli BuilJin� <br />WORK I]ESGRIPTION <br />ADDRESf'i <br />HEAT SOURCC- <br />� [lettric Gas Other <br />CITY2IP PHONE <br />CJNTRACT PRICc OF WORK <br />595,000.00 <br />Providc buildinR altcr:�tions for � Nc« Po«cr ltoom in thc 13:�scmcnt and espand thc Existin�; Po��•cr <br />Kuom on thc First Fluor includin� associatcd ntcchanical anJ clectrical allcrations. <br />NO. I TYPE OF FlXTI!RE OR ITLM <br />Toilet <br />Bathlub <br />Levatory (wash basio) <br />Shower <br />Kitchen sink & dispcaal <br />Dlshwasher <br />Clolhos washer <br />LaunCry tray <br />Sink (sorvice/badmopletc.) <br />Bar kflow preventer <br />Uiinal <br />�rinking Fountain <br />Fbot drein <br />Grease trap <br />Roof drains <br />i Olher <br />MECHANICAI. <br />NO. I TYPE OF FIXIURE OR ITtiM <br />A/C — air handling units <br />Forced alr syslems <br />Gas piping <br />Water h0ator <br />Gas freplace <br />� Gns rango <br />� Cbthos tlryer <br />Rango hood <br />� Exhaustfan <br />I loat pump <br />UNI heater <br />Boilor <br />Retrigrration <br />Woodstova <br />q7Y OF EVERETT LOCAI. SALCS TA% CODE IS 9105 <br />I hereby ceritify that I hnve read and examined this appllcation and know Uie samo to bo We and corroct. All pro��sions of laws and <br />ordlnaces goveming thls ty�w of work will be complied with wlielher speciflad hor�in or not. The granling of a permil dces not prosume <br />to give aulhonty tn olate or cancel lho provision of any other stato or bcal law regulaling conshucUon or tho performance of <br />conswction. That i am authorized by the owner oi this property lo peAorm Iho �rork for whlch application i� made and ( comply wtth the <br />Slaie Contractors law 10.27 RCW and 296.200 WnC. <br />/ .i ./ _ . / / <br />�(Z <br />,�';�4; . _ '4, ,.,� . <br />r <br />,.. . :*,. � <br />