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PERMIT APPLICATIC& <br />BUILDIN MECHANICAL / PLUMBING / SIGN SPRINKLER / 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& Colby Avenue - Everett, WA 98203 <br />PROPERTY TAX #: 00517155100100 <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 #2 - Attn. Darcy Walker TENANT NAME (If Commercial): Everett High School - Bldg B (Auditorium) <br />OWNER MAILING ADDRESS: STREET 3900 Broadway <br />cITY Everett STATE WA zIF 98201 <br />OWNER PHONE: 425-385-4190 <br />OWNER EMAIL: dwalker@everettsd.org <br />CONTRACTOR NAME: TBD --� <br />CONTRACTOR ADDRESS: STREET / 5 Fi (a c7v Qt l l i; l Sb,t Kd - <br />WVG Jz <br />CITY ��.� STATE A zip / s 93 <br />CONTRACTOR PHONE: S b o -• ;�S' f- - Z3 fi 3 <br />CONTRACTOR EMAIL: y ocja rke+; <br />CONTRACTOR LICENSE #(REQUIRED): <br />CITY OF EVERETT BUSINESS LICENSE #(REQUIRED): S ,S e7 , <br />PRIMARY CONTACT: ❑ OWNER ❑ CONTRACTOR ;R OTHER (Please Specify) <br />CONTACT NAME: <br />Corey Wright <br />CONTACT PHONE: 425-259-3161 <br />CONTACT EMAIL: coreyw@dykeman.net <br />BUILDING PERMIT APPLICATION <br />Existing Use of Building: Education <br />Contract Price of Work: $ U4 000- <br />Proposed Use of Building: Education No Change) <br />Heat Source: ❑Gas ❑Electric ❑Other <br />Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi -Family-# of Units: WCommercial ❑Industrial <br />Type of Project: ❑New ❑Addition [ORemodel ❑Repair 13T.1. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br />DESCRIPTION OF WORK: <br />Interior tenant improvement consisting of removal and replacement of interior finishes, lighting, and minor demolition to existing non -bearing walls and doors. <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 />Fixtures <br />List of Fixtures <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 / SUPPRESSION <br />SYSTEM <br />Chemical or Water I <br />I 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 / 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 />PERMIT <br />(Revised 912312016) <br />