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PERMIT APPLICATION ► <br /> BUILDINIECHANICAL/ PLUMBING /SIG('J I SPRINKLER/ DEMOLITION <br /> E V E R E T TCITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> WASHINGTON (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> (Blue o Black Ink Only,please).:£ - <br /> 41-90400*,SITE INFORMATIO I.. -: ,, n , ,t ` , litif <br /> PROJECT SITE ADDRESS:4933 Evergreen Way Everette,WA 98203 PROPERTY TAX#:00581900000101 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> < - - CONTACT:INFORMATION , <br /> OWNER NAME: Claremont Village Station LLC TENANT BUSINESS NAME(Commercial): Vera for City of Everett <br /> OWNER MAILING ADDRESS: STREET 11501 Northlake Dr <br /> cny Cincinnati STATE OH ZIP 45249 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME:Swinerton Buildiers <br /> CONTRACTOR ADDRESS: STREET 14432 SE Eastgate Way,Suite 230 <br /> crr Bellevue STATE WA ZIP 98007 <br /> CONTRACTOR PHONE: 425.283.5252 CONTRACTOR EMAIL: 425.283.5252 (''►� <br /> CONTRACTOR LICENSE#(REQUIRED):55J/fAN/E '17 ZbR CITY OF EVERETT BUSINESS LICENSE#(REQUI "1 <br /> PRIMARY CONTACT: El OWNER 0 CONTRACTOR 0 OTHER(Please Specify) V�/ <br /> CONTACT NAME: CONTACT PHONE:425.463.6745 <br /> Nick Vovakes CONTACT EMAIL:nvovakes@swinerton.com <br /> WaJrVAIISMSWSftnn,f;,tgafiZBUtOINOINPORMATCON ;. aftl_,Rfa*,,.,Mlrtt,Mfou <br /> Existing Use of Building:Retail Contract Price of ork:$27,104 <br /> Proposed Use of Building:Clinic Heat Source: ❑Gas tiectrnc ■Other <br /> BUILDING USE: ❑SFR ❑Townhouse ❑Duplex ❑ADU EMulti-Family-#Units: ECommercial ❑Accessory Structure <br /> Type of Project: ❑New EAddition ❑Remodel ❑Repair ❑T.I. ❑Sign ESprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: Demo of all interior walls, doors, ACT ceilings, over-framed ramp and plumbing fixtures. <br /> Existing exterior walls, demising wall and interior columns to remain. <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL'PERIVIIT APPLIC/4TION, >, , , , PLUMBING PERMIT APP,LICATIONy` `„-, , s <br /> Fixture Fixture Fixture Fixture <br /> Count List of Fixtures count List of Fixtures Count List of Fixtures Count List of Fixtures <br /> NC—Air Handling Units Gas Piping Backflow Preventer(Inside Bldg) Shower,Tub,or Combo <br /> Boiler Gas Range Clothes Washer Sink-Commercial(3-comp,prep,floor) <br /> Clothes Dryer Heat Pump&Ductless Dishwasher Sink-Residential(kitchen,bath,bar) <br /> Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility,laundry,mop <br /> Exhaust Fans(Residential) Commercial Ventilatior Floor Drain s Toilet <br /> Exhaust Hood(Type I) (Not Heat/AC system) Hose Bibb Urinal <br /> Exhaust Hood(Type II) Water Heater Interceptor-Grease Waste/Water Piping Repair <br /> Exhaust Hood(Residential) Wood Stove Interceptor-Sand/Oil Water Service(behind meter) <br /> Forced Air Systems Other: Medical Gas Water Valves or Fixtures <br /> Gas Fireplace/Insert/Log Roof Drains Water Heater <br /> SPRINKLER I SUPPRESSION SYSTEM z' Sewage Ejector or Sump Pump Other: <br /> Water Suppression System No.of Heads <br /> Chemical Suppression System 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 /> and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> PE T# <br /> OZ/Z-06 <br /> 2 5 <br /> 3 net/Auth• ''Agent Signature Date (Revised 10/10/2018) <br /> �l� <br />