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0 PERMIT APPLICATION <br />BUILDING / MECHANICAL / PLUMBING / SIGN / SPRINKLER / DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />OL 3200 CEDAR STREET, EVERETT, WA 98201 <br />(P) 425-257-8810 1 FAX 425-257-8857 1 (E) everetteps@everettwa.gov I www.everettwa.gov/permits <br />(Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br />PROJECT SITE ADDRESS: 271 5 Everett Ave <br />1PROPERTY TAX #: 29052000406900 <br />LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />CONTACT INFORMATION <br />OWNER NAME: Bethany Christian Assembly (Paul Banas) TENANT NAME (If Commercial): Verizon Wireless <br />OWNER MAILING ADDRESS: STREET 2715 Everett Ave <br />c,Ty Everettt STATE WA zip 98201 <br />OWNER PHONE: 425-339-3303 X. 109 <br />1OWNER EMAIL: <br />CONTRACTOR ME: TBD pending bid award `/�j <br />e' <br />RESS: -STREET � <br />CONTRACTOR A15DRESS: --�_ _T r O 2,'�I <br />'d^ <br />CITY ,J/�� ' �/ ' STATE ZIP <br />CONTRACTOR PHONE: <br />CONTRACTOR EMAIL: <br />CONTRACTOR LICENSE #(REQUIRED): <br />CITY OF EVERETT BUSINESS LICENSE #(REQUIRE ): <br />PRIMARY CONTACT: ❑ OWNER ❑ CONTRACTOR ZI OTHER (Please Specify) MD7 On behalf of Verizon (consultant <br />CONTACT NAME: <br />Becky Todd <br />CONTACT PHONE: 206-310-1793 <br />CONTACT EMAIL: btodd@md7.com <br />BUILDING PERMIT APPLICATION <br />Existing Use of Building: Church and storage sheds Contract <br />Price of Work: $ <br />Proposed Use of Building: church, storage shed, equipment shed I Heat <br />Source: []Gas ❑Electric ❑Other <br />Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi -Family-# of Units: Commercial ❑Industrial <br />Type of Project: ❑New ❑Addition ❑Remodel ❑Repair VI T.I. ❑Sign ❑Sprinkler ❑Demolition Change of Use <br />DESCRIPTION OF WORK: <br />Install 3 panel antennas on replacement utility pole. replace existing storage building with new storage structure and install radio and battery cabinets in the covered/unenclosed portion of the building. <br />ASSOCIATED BUILDING PERMIT # (if applicable): <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _ Addn _Alteration _Repair <br />Type of Project: New _Addn _Alteration _Repair <br /># of <br />Fixtures <br />List of Fixtures <br /># of <br />Fixtures <br />List of Fixtures <br /># of <br />Fixtures <br />List of Fixtures <br /># of <br />Fixtures <br />List of Fixtures <br />A/C —Air Handling Units <br />Heat Pump <br />Toilet <br />Backflow Preventer (Inside Bldg) <br />Forced Air Systems <br />Unit Heater <br />Bathtub <br />Urinal <br />Gas Piping <br />Boiler <br />Lavatory (Wash Basin) <br />Drinking Fountain <br />Water Heater <br />Refrigeration <br />Shower <br />Floor Drain <br />Gas Fireplace <br />Wood Stove <br />Kitchen Sink & Disposal <br />Grease Trap <br />Gas Range <br />Ducting <br />Dishwasher <br />Roof Drains <br />Clothes Dryer Hookups <br />Other: <br />Clothes Washer <br />Medical Gas <br />Range Hood <br />Water Heater <br />Other: <br />Exhaust Fan <br />Sink (Service/Bar/Mop/etc.) <br />Other: <br />SPRINKLER <br />/ SUPPRESSION <br />SYSTEM <br />Number of Heads <br />ACKNOWLEDGEMENT: / 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 />PER I #�(( 2. — `/-'/yl.Jl <br />„�� <br />(Revised 9/23/2016) 7kJ <br />