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PERMIT APPLICA*N <br />BUILDIG / MECHANICAL / PLUMBING / SIGN / SPRINKLER / DEMOLITION <br />EVERETT 32CITY OF EVERETT PERMIT SERVICES <br />00 CEDAR STREET, EVERETT, WA 98201 <br />WASHINGTON (P)425-257-8810 1 FAX425-257-8857 1(E)everetteps@everettwa.govI www.everettwa.gov/permits <br />(Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br />PROJECT SITE ADDRESS:3700 Federal Ave, Everett, WA 98201 <br />1PROPERTY TAX #:00605000500000 <br />LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br />CONTACT INFORMATION <br />OWNER NAME: Everett Public Schools TENANT BUSINESS NAME (Commercial): Jackson ES <br />OWNER MAILING ADDRESS: STREET3900 Broadway <br />CITY Everett STATE WA ZIP 98201 <br />OWNER PHONE: (425) 385-4000 <br />OWNER EMAIL:jcolllrlS@everettSd.Org <br />CONTRACTOR NAME: <br />CONTRACTOR ADDRESS: STREET <br />CITY STATE ZIP <br />CONTRACTOR PHONE: <br />CONTRACTOR EMAIL: <br />CONTRACTOR LICENSE #(REQUIRED): <br />CITY OF EVERETT BUSINESS LICENSE #(REQUIRED): <br />PRIMARY CONTACT: ❑ OWNER ❑ CONTRACTOR El OTHER (Please Specify) Architect <br />CONTACT NAME: <br />Steve Lee, Studio Meng Strazzara <br />CONTACT PHONE: 206-587-3797 <br />CONTACT EMAIL: SLee@StudiomS.Com <br />BUILDING INFORMATION <br />Existing Use of Building: Portable Classroom <br />Contract Price of Work: $ 25,000 <br />Proposed Use of Building: Portable Classroom <br />Heat Source: ❑Gas ©Electric []Other <br />BUILDING USE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi -Family - # Units: ❑✓ Commercial ❑Accessory Structure <br />Type of Project: ❑New ❑✓ Addition ❑Remodel ❑Repair LIT. 1. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br />DESCRIPTION OF WORK: Relocation of (1) 28'x32' Portable Classroom owned by Everett Public Schools to Jackson ES. <br />ASSOCIATED BUILDING PERMIT # (if applicable): <br />MECHANICAL <br />PERMIT <br />APPLICATION <br />PLUMBING PERMIT <br />APPLICATION <br />Fixture <br />Count <br />List of Fixtures <br />Fixture <br />count <br />List of Fixtures <br />Fixture <br />Count <br />List of Fixtures <br />Fixture <br />Count <br />List of Fixtures <br />A/C - Air Handling Units <br />Gas Piping <br />Backflow Preventer (Inside Bldg) <br />Shower, Tub, or Combo <br />Boiler <br />Gas Range <br />Clothes Washer <br />Sink -Commercial (3-comp,prep,floor) <br />Clothes Dryer <br />Heat Pump&Ductless <br />Dishwasher <br />Sink -Residential (kitchen, bath, bar) <br />Duct System (Remodel) <br />Refrigeration <br />Drinking Fountain <br />Sink -Utility, laundry, mop <br />Exhaust Fans (Residential) <br />Commercial Ventilatior <br />(Not Heat/AC system) <br />Floor Drain <br />Toilet <br />Exhaust Hood (Type 1) <br />Hose Bibb <br />Urinal <br />Exhaust Hood (Type II) <br />Water Heater <br />Interceptor -Grease <br />Waste/Water Piping Repair <br />Exhaust Hood (Residential) <br />Wood Stove <br />Interceptor-Sand/Oil <br />Water Service (behind meter) <br />Forced Air Systems <br />Other: <br />Medical Gas <br />Water Valves or Fixtures <br />Gas Fireplace/Insert/Log <br />1 <br />1 Roof Drains <br />lWater Heater <br />SPRINKLER / SUPPRESSION <br />SYSTEM <br />Sewage Ejector or Sump Pump <br />Other: <br />Water Suppression System <br />No. of Heads <br />Chemical Suppression System <br />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 />PERM ZD 0 I I ` <br />(Revised 1011012018) / J j <br />