10330 4TH AVE W 2020-05-21 - Laserfiche WebLink

4:77" PERMIT APPLICATI BUILDIN_ MECHANICAL/ PLUMBING / SIG uPRINKLER / DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 1 FAX 425-257-8857 1 (E)everetteps@everettwa.gov 1 www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: 10330 4TH AVE W, EVERETT, WA 98204-390 PROPERTY TAX#: 00518200001101 LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: SNH/LT PROPERTIES TENANT NAME(If Commercial): SOUTH POINT OWNER MAILING ADDRESS: STREET 10315 5TH PL W crry EVERETT STATE WA ZIP 98204 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: ` (e \y 14 t' , ( A1' , CONTRACTOR ADDRESS: STREET r.cu it- I/1 Oita ei 1't(i j' cm _- STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED):C—.)1-11)),--:, PRIMARY CONTACT: ❑ OWNER ❑ CONTRACTOR V OTHER (Please Specify) CONCEPT ARCHITECTURE CONTACT NAME: CONTACT PHONE: 425.377.8786 MARTIN REIMERS, AIA CONTACT EMAIL: MREIMERS©CONCEPTARCHITECURE.0 BUILDING PERMIT APPLICATION oo Existing Use of Building:ASSISTED LIVING FACILITY Contract Price of Work: $ 913B7. ______ Proposed Use of Building: Heat Source: ❑Gas ❑Electric DOther Building Type: DSFR-Detached DSFR-Attached ❑Duplex DMulti-Family-#of Units: OCommercial Dlndustrial Type of Project: ❑New DAddition Remodel DRepair DTA. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: r v-D r YVVp 1 ; c' .�� c9 1A 40 r p ,,r r V.N v- UVB i-� a v A. C-u r r e h� A .ed -Qowx L i-�- -4-0 a r► `Uy e \ ✓V-c, v 1 o Vk 2skU - oUvvt-i , ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Type of Project: _New _ Addn _Alteration Repair Type of Project: New _Addn _Alteration _Repair #of #of #of #of Fixtures List of Fixtures Fixtures List of Fixtures Fixtures List of Fixtures Fixtures List of Fixtures _ NC—Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) _ Forced Air Systems Unit Heater Bathtub Urinal _ Gas Piping Boiler Lavatory (Wash Basin) Drinking Fountain _ Water Heater Refrigeration Shower Floor Drain Gas Fireplace Wood Stove Kitchen Sink& Disposal Grease Trap Gas Range Ducting Dishwasher Roof Drains _ Clothes Dryer Hookups Other: Clothes Washer Medical Gas Range Hood Water Heater Other: Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: SPRINKLER/ SUPPRESSION SYSTEM Chemical or Water I No. of Heads 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 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 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, and I comply with the Sta.•Contractors La 18.27 RCW and 296.200A WAC. City of Everett Official Use Only r PERMIT#,) ! � i►_.w.ill ( ,,,-- ------- /Uf_..ty ,/ ) n\Li Own.. tho ze. .gent Signature Date (Revised 9/23/2016) .. Vz_