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PERMIT APPLICAT <br /> BUILD!, MECHANICAL/ PLUMBING /SIW SPRINKLER/ 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: 1920 Merrill Creek Parkway PROPERTY TAX#:28040200401100 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION, <br /> OWNER NAME: LBA Realty ‘ctp2._S `-1-2-- TENANT BUSINESS NAME(Commercial): Market Ready <br /> OWNER MAILING ADDRESS: STREET600 University St,STE 3025 <br /> cry Seattle STATE WA ZIP 98101 <br /> OWNER PHONE: 206.812.1000 OWNER EMAIL:RBeckley@lbarealty.com <br /> CONTRACTOR NAME:TBD <br /> CONTRACTOR ADDRESS: STREET TBD <br /> CITE TBD STATE WA ZIP <br /> CONTRACTOR PHONE:TBD CONTRACTOR EMAIL:TBD <br /> CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): <br /> PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR 0 OTHER(Please Specify) JPC Architects <br /> CONTACT NAME: CONTACT PHONE:425 641 9200 <br /> Teresa Portman CONTACT EMAIL:teresap@jpcarch' cts.co <br /> BUILDING INFORMATION <br /> Existing Use of Building:B(Office)&F(Warehouse) Contract Price of W rk:$400,000 <br /> Proposed Use of Building:B(Office)&F(Warehouse) Heat Source: 0 s ❑Electric ❑Other <br /> BUILDING USE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑✓Com rcial ❑Accessory Structure <br /> Type of Project: 'New ❑Addition ❑Remodel ❑Repair I JT.I. ❑Sign ❑Sprin r molition ❑Change of Use <br /> DESCRIPTION OF WORK: Non structural tenant improvement including demolition of existing partitions, doors, G@Str a- intro'" <br /> fIxtcrfe4, r c u e new res ,ti <br /> mg • g t. <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 Fixt -s Count List of Fixtures Count Lis • Fixtures <br /> A/C—Air Handling Units Gas Pipi. Backflow Preventer(Inside Bldg) Shower ub,or Combo <br /> Boiler Gas range Clothes Washer Si ommercial(3-comp,prep,floor) <br /> Clothes Dryer .-at Pump&Ductless Dishwasher ink-Residential(kitchen,bath,bar) <br /> Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility,laundry,mop <br /> Exhaust Fans(Residential) Commercial Ventilatior 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(Res::ential) Wood Stove Interceptor-Sand/Oil Water Service(behind meter) <br /> Forced Air Syst= "s Other: Medical Gas Water Valves or Fixtures <br /> Gas Firepla Insert/Log Roof Drains, Water Heater <br /> SPRIN ER f SUPPRESSION SYSTEM Sewa.• jector or Sump Pump Other: <br /> Water Suppre on System No.of Heads <br /> Chemical Suppression System I INo.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 <br /> Teresa Portman �J���c�s.E.�.,.,e;a,�w�,e.,�,o_���c���.�,,«c�.oN.r.,.uPw� 4/22/20 -06"1 <br /> Owner/Authorized Agent Signature Date (Revised 10/10/2018) <br />