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PERMIT APPLICATIO <br /> ECHANICAL / PLUMBING / SIGN /�IPRINKLER / DEMOLITION <br /> EVERETT CITY 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 or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS:12115 19th Avenue SE, Everett WA PROPERTY TAX#:28052900202700 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Andrew Wolper TENANT BUSINESS NAME(Commercial): Aukum Management LLC <br /> OWNER MAILING ADDRESS: STREET900 Larkspur Landing Circle Suite 100 <br /> CITY Larkspur STATE CA ZIP 94939 <br /> OWNER PHONE: 303-324-2479 OWNER EMAIL:andrew@aukum.com <br /> CONTRACTOR NAME: g0 14-0)5 <br /> CONTRACTOR ADDRESS: STREET <br /> CITY 2..e4b(A.A.49(/lA STATE ( ZIP CtZa S <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: ���lll <br /> CONTRACTOR LICENSE#(REQUIRED)70E.Ar ZW DCk nCITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 5Ct <br /> PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR 0 OTHER(Please Specify) Architect <br /> CONTACT NAME: CONTACT PHONE:503.889.0604 <br /> Jonathan Dunn CONTACT EMAIL:jonathan@wblock.com <br /> BUILDING INFORMATION <br /> Existing Use of Building:B,A-2 Contract Price of Work: $20QZ000 '754 <br /> _60 4/AL/44,ifid <br /> Proposed Use of Building:B,A-2 Heat Source: ❑Gas ❑Electric ❑Other a'f C/A44 r <br /> BUILDING USE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑✓Multi-Family-#Units: ❑Commercial ❑✓Accessory Structure <br /> Type of Project: ❑New ❑Addition ❑✓Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: Interior remodel of clubroom, fitness and leasing lobby spaces. Minor exterior work including replacing <br /> and adding doors, windows and siding. Site work to include new concrete pads and new ADA parking spaces. <br /> Exterior Gazebo added near pool deck. <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Fixture Fixture Fixture Fixture <br /> Count List of Fixtures Count List of Fixtures Count List of Fixtures Count List of Fixtures <br /> A/C—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 Ventilation _Floor Drain 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 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 /> Psi <br /> Jonathan Dunn c 07.24.20 <br /> 8� o, <br /> Owner/Authorized Agent Signature Date (Revised 10/10/2018) <br />