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PERMIT APPLICATIdN
<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 � FAX 425-257-8857 �(E)everetteps@everettwa.gov� www.everettwa.gov/permits
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<br /> PROJECT SITE ADDRESS: 3003 W Casino Rd. PROPERTY TAX#: Zg041000100200 ��
<br /> LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description)
<br /> ` �f, , ,� �QNTA'C,'T IN�ORMA'f;ION ;�
<br /> OWNER NAME: Boeing Co TENANT NAME(If Commercial): i
<br /> OWNER MAILING ADDRESS: srReer PO Box 3707 M/S OH-13 �
<br /> ciry Seattle s-rnTe WA ziP 98124-2207
<br /> OWNER PHONE: 425-260-2668 OWNER EMAIL: todd.j.haberlack@boeing.com
<br /> CONTRACTOR NAME:Gene�al C011St1'UCt1011
<br /> CONTRACTORADDRESS: sTReer33455 6tF1 AVe S i
<br /> ciry Federal Way sTATE WA ��P 98003
<br /> CONTRACTOR PHONE:(253) 943-4200 CONTRACTOR EMAIL:RICh.SCtllth@k12WIt.00111 �
<br /> CONTRACTOR LICENSE#(REQUIRED):GENERCC9H3OZ CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): O4O�J99
<br /> PRIMARY CONTACT: I�OWNER ❑CONTRACTOR ❑OTHER(Please Specify)
<br /> CONTACT NAME: CONTACT PHONE: 425-260-2668
<br /> Todd Haberlack coNracT ennAi�: todd.j.haberlack@boeing.com
<br /> �' ,, r =BUILDIN„C� PERMIT A�P�.�E�'r/�1,�"IQN ` '�,;���, ,'
<br /> Existing Use of Building: N/A Contract Price of Work:$1,000,000
<br /> Proposed Use of Building: Heat Source: ❑Gas ❑Electric ❑Other
<br /> Buildin T pe: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial �Ilndustrial
<br /> Type of Project: ❑New Addition ❑Remodel ❑Repair �T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use
<br /> DESCRIPTION OF WO � 40-25 1st floor column L9-Install concrete walls,structural fill,and new concrete slab to support a new production system
<br /> for the 777X WBJ position.
<br /> ASSOCIATED BUILDING PERMIT# if a licable :
<br /> ; : , 9 � E J - � � � , t s
<br /> ,;:a.��,���,,.iV1�+�M�/!�I�t`��IIk,L�P�RNN�lT��1�`PLt�TIQN<,�;;����i����. �;�.., ,., ,,,.�_,�.,"���11�I,B,ING PEi'�11�1IT lolPP:l,I ATIO�1 � ' ;,�i;;
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<br /> Type of Project: _New Addn _Alteration _Reqair Type of Project: _New Addn Alteration Repair
<br /> #of List of Fixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures
<br /> Fixtures Fixtures Fixtures Fixtures
<br /> A/C—Air Handling Units Heat Pump Toilet Backflow Pre er(Inside Bldg)
<br /> Forced Air Systems Unit ater Bathtub Urinal
<br /> Gas Piping er Lavatory(Wash Basin) D ' ing Fountain
<br /> Water Heater Refrigeration Shower Floor Drain
<br /> Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap
<br /> Gas Range Ducting Dishwasher Roof Drains
<br /> Clothes D er Hookups Other: Clothes Washer Medical Gas
<br /> Range Hood Water Heat Other:
<br /> Exhaust Fan Sink(Service/Bar/Mop/etc.) Other:
<br /> ~.SPRINKLER�.SUP,PR�$SION,SYSTEM;,;;�`,.
<br /> Number 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 /> `���/I L/`� //� PE # O- r —
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<br /> Owner/Authorized Agent Signature Date (Revised 0/12/2015)
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