Laserfiche WebLink
PERMIT APPLICATION <br /> BUILDING/ MECHANICAL/PLUMBING /SIGN /SPRINKLER/ DEMOLITION <br /> ! CITY OF EVERETT PERMIT SERVICES <br /> �� � �" 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 i FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: 6707 Hardeson Rd,Everett,WA 98203-7101 PROPERTY TAX#: 28040200401900 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) SEE ATTACHED <br /> R <br /> CONTACT INFORMATION <br /> OWNER NAME: Umbra Cuscinetti Inc(Attn.Ryan Rayburn) TENANT NAME(If Commercial): Umbra Cuscinetti Inc <br /> OWNER MAILING ADDRESS: STREET 6707 Hardeson Rd <br /> ciTY Everett STATE WA ZIP 98203-7101 <br /> OWNER PHONE: 425-405-3521 OWNER EMAIL: RRayburn@umbrausa.com <br /> CONTRACTOR NAME: 11714 <br /> 7 D ••/ mit ((,€1/ (g-‘,44- cI3ry I <br /> CONTRACTOR ADDRESS: STREET I b'3)-) c S'il- AV e I/� / j ' YOtJ <br /> CITY g 0 t k 0I Q STATE ULZIP ' f <br /> CONTRACTOR PHONE: (p— 41-5-4,-- 33')3L( CONTRACTOR EMAIL: J irH,r e i4t 1t jAc. .tn,.er <br /> CONTRACTOR LICENSE#(REQUIRED): 05-a 5'S'(® yVtZL. k€f:-CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): <br /> PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR I]OTHER(Please Specify) Architect <br /> CONTACT NAME: Scott Connor(SCR Architects) CONTACT PHONE: 206-228-1014 <br /> CONTACT EMAIL: scott@scr-arch.com <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: Manufacturing Contract Price of Work:$ 30,000 <br /> Proposed Use of Building: Manufacturing(no change) Heat Source: ❑Gas 0Electric ❑Other <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ODuplex ❑Multi-Family-#of Units: ❑x Commercial [Industrial <br /> Type of Project: ❑New ❑Addition ❑Remodel ❑Repair CIT.!. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: <br /> foundation for automated milling machines in existing manufacturing/warehouse building. <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New x Addn _Alteration _Repair Type of Project: _New _Addn _Alteration _Repair <br /> #of #of <br /> List of Fixtures #of List of Fixtures #of List of Fixtures List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> A/C–Air Handling Units mp 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 INo.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 /> and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of 11061—DS Official Use Only�} <br /> „/Zil."---om" PERMIT# dt/ 1��B J��C/ <br /> 8/24/2017 <br /> Owner/Authorized Agent Signature Date (Revised 9/23/2016) <br /> ('''' _ <br />