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PERMIT APPLICATIO—■ <br /> BUILDINCH-11ECHANICAL/PLUMBING/SIGRINKLER/ DEMOLITION <br /> /1111:04010%/4---A <br /> ' CITY OF EVERETT PERMIT SERVICES <br /> , 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: 840 N Broadway Bldg A,JR PROPERTY TAX#: 00551300001900 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: GPT Properties Trust TENANT NAME(If Commercial) <br /> OWNER MAILING ADDRESS: STREET Two Newton PI 255 Washington St <br /> cm( Newton STATE MA zip 02458 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: PULCON <br /> CONTRACTOR ADDRESS: STREET 12045 LAKESIDE PL NE <br /> ciT' SEATTLE STATE WA ZIP 98125 <br /> CONTRACTOR PHONE: 206-306-9080 r CONTRACTOR EMAIL: PULCON@COMCAST.NET k� I2 "i (1, 1.7q/_,CONTRACTOR LICENSE#(REQUIRED): V UAL C O1 51 k-1- CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 1*ol—i() <br /> PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR p OTHER(Please Specify) Designer/Architect <br /> CONTACT NAME: CONTACT PHONE: 425-885-4300 <br /> Clover Schuler CONTACT EMAIL: clover@magellanarchitects.com <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building:B Contract Price of Work:$ 13,500 <br /> Proposed Use of Building: B Heat Source: ❑Gas ❑Electric ❑Other <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: IaCommercial ❑Industrial <br /> Type of Project: El New ❑Addition El Remodel ❑Repair T.I.O ❑Sign ❑Sprinkler CI Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: <br /> 900 S.F. Interior office remodel for existing tenant space including new walls, doors and windows. <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New _ Addn Alteration _Repair Type of Project: _New _Addn Alteration _Repair <br /> #of List of Fixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> NC—Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) <br /> Forced Air Systems Unit Heater Bathtub Urinal <br /> Gas Piping Boiler Lavatory(Wash Basin) Drinking Fountain <br /> Water Heater Refrigeration Shower Floor Drain <br /> Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap <br /> Gas Range Ducting Dishwasher Roof Drains <br /> Clothes Dryer Hookups Other: Clothes Washer Medical Gas <br /> Range Hood Water Heater Other: <br /> Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: <br /> SPRINKLER/SUPPRESSION SYSTEM <br /> Chemical or Water I No.of Heads <br /> ACKNOWLEDGEMENT:I have reviewed this application and confirm the information contained herein is true and correct. Work done pursuant to this permit must comply with <br /> current federal,state,and local law.The granting of a permit only authorizes approved work and no deviations therefrom.Deviations must first be authorized in writing from the <br /> Building Official before being authorized under any circumstance.I am the owner,or I am authorized by the owner of this property to perform the work for which application is made, <br /> andI c• ply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> / 10 PERMIT# 12 Q 3(. 1 -0( <br /> 0 <br /> 0 Authorized A,- ig - e D. e (Revised 9/23/2016) <br />