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PERMIT APPLICATIOP' <br />BUILDINUOMECHANICAL / PLUMBING / SIGNAPRINKLER / DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />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: 616 Pecks Dr, Everett, WA 98203 <br />1 PROPERTY TAX #: 28050600302000 <br />LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br />CONTACT INFORMATION <br />OWNER NAME: Everett School District TENANT NAME (If Commercial): Everett School District <br />OWNER MAILING ADDRESS: STREET 3900 Broadway <br />CITY Everett STATE WA zip 98201 <br />OWNER PHONE: (425) 385-4195 <br />OWNER EMAIL: jcollins@everettsd.org <br />CONTRACTOR NAME: <br />CONTRACTOR ADDRESS: s REET CJ <br />CITY STATE ZIP <br />CONTRACTOR PHONE: <br />CONTRACTOR EMAIL: <br />CONTRACTOR LICENSE #(REQUIRED): 3 <br />CITY OF EVERETT BUSINESS LICENSE #(REQUIRED): <br />PRIMARY CONTACT: ❑ OWNER ❑ CONTRACTOR ® OTHER (Please Specify) Architect <br />CONTACT NAME: <br />Zach Ham <br />CONTACT PHONE: (425) 259-3161 <br />CONTACT EMAIL: ZachH@dykeman.net <br />BUILDING PERMIT APPLICATION <br />Existing Use of Building: Educational: Group E <br />Contract Price of Work: $ I <br />Proposed Use of Building: Educational: Group E <br />Heat 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 ❑T.I. ❑Sign ❑Sprinkler ❑Demolition []Change of Use <br />DESCRIPTION OF WORK: <br />(1) new 887 SF portable P1, landing, and ramp to be installed at elementary school. <br />ASSOCIATED BUILDING PERMIT # (if applicable): <br />MECHANICAL <br />PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project: <br />New _ Addn _Alteration <br />_Repair <br />Type of Project: New _Addn <br />_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 />IDucting <br />Dishwasher <br />I 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 />Chemical or Water <br />No. of Heads <br />ACKNOWLEDGEMENT: 1 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 RC and 296.200A WAC. <br />, <br />Zachary HamdvkPmw Mo.o,k.m,a,n„an.. <br />Owner/Authorized Agent Signature Date <br />City of Everett Official Use Only <br />PERMIT # <br />(Revised 912312016) r' <br />