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ELI PERMIT APPLICATIK <br /> BUILDING I MECHANICAL/PLUMBING!SiGN 1 SPRINKLER I 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 1 FAX 425-257-8857 1(E)everetteps a(evere(twa.gov f wwweverettrwa govtpermits <br /> ILEMoe or Black INS Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: 821 West Casino Road !PROPERTY TAX#:28041200300600 <br /> GA <br /> for new construction: Short Piatlsubdivision Attached Lot No. (attach copy of long legal ) <br /> CONTACT INFORMATION <br /> OWNER NAME: Bible Baptist Church TENANT BUSINESS NAME(Commercial): Hand in Hand <br /> OWNER MAILING ADDRESS: sexrte 9502 19th Ave SE Suite F <br /> cur Everett STATE WA zw 98208 <br /> OWNER PHONE:425-353-6200 OWNER EMAIL: BobR@biblebaptistchurch.net <br /> biblebaptistchurch.net <br /> CONTRACTOR NAME: Hand in Hand <br /> CONTRACTOR ADDRESS: STREET 9502 19th Ave SE Suite F <br /> cnv Everett STATE WA as, 98208 <br /> CONTRACTOR PHONE:425-754-2662 CONTRACTOR EMAiL:todd©handinhandkids.org <br /> CONTRACTOR LICENSE#(REQUIRED): ICilY OF EVERETT BUSINESS LICENSE#(REQUIRED): <br /> PRIMARY CONTACT: D OWNER D CONTRACTOR El OTHER(Please Specify) Hand in Hand <br /> CONTACT NAME: CONTACT PHONE:425-754-2662 <br /> Todd McNeal CONTACT E :todd a©handinhandkkis_org <br /> BUILDING INFORMATION <br /> Existing Use of Building:Single Family Contract Price of Work:$ 100,000 <br /> Proposed Use of Building:-F4WASF-Getre-S 1.),..)6-LE FAA I)-(-3 Heat Source: OGas DEiectric DOther <br /> BUILDING USE: DSFR OTownhouse []Duplex DADU OMulti-Family-#Units: DCommercial DAccessory Structure <br /> Type of Project DNew DAddition ORemodel ,, Repair DT.I. OSign DSprinkler ODemolition OChange of Use <br /> DESCRIPTION OF WORK: 2. A?a_ let),J0 i .eyl oo <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION` PLUMBING PERMIT APPLICATION <br /> Fi:trrre List of Fixtures rope List of Fixtures List of lixtu,ES Rxture � � List of Rtxtues <br /> wer <br /> Count coCourt count <br /> A/C—Mr Handling Units Gas Piping Backflow Preventer(Inside Bldg) I Shower,Tub,or Combo <br /> Boiler Gas Range Clothes Washer Sink Commercial(3-comp,piep,floor) <br /> Clothes Dryer 4 Heat Pump&Ductless Dishwasher 4 Sink-Residential(kitchen,bath,bar) <br /> Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility,laundry,mop <br /> 2 Exhaust Fans(Residential) Commercial Ventilatior Floor Drain 2 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 /> I Exhaust Hood(Residential) Wood Stove interceptor-Sand/Oil Water Service(behind meter) <br /> Forced Air Systems Other: Medical Gas 8 Water Valves or Fixtures <br /> Gas Firepiacefinsert/Log Roof Drains Water Heater <br /> SPRINKLER 1 SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other <br /> atm Suppression System No.("Heads <br /> Suppression System I No.of Heads <br /> ACKNOWLEDGEMENT::!have reviewed this application and confirm the information contained herein is true and coned.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.lam 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 /> PERMIT#0 \. <br /> __//( ' .... '7-1 -/ 1 <br /> i °1101 66) -----, <br /> Owner/Authorized Agent Signature Date (Revised 10110!2018) <br />