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/N744.64 <br /> vagi 10 --- <br /> .,.. _ <br /> PERMIT APPLICATIt <br /> BUILDING /MECHANICAL I PLUMBING /SIGN /SPRINKLER /DEMOLITION (.......1_,„ <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps©everettwa.gov I www.everettwa.gov/permits <br /> to or Black Ink Only Plaits') PROJECT SITE INFORMATION <br /> r'nOJECT SITE ADDRESS: 3130 Broadway, Everett WA 98201 <br /> LEGAL fry new construction Short Plat/subdivision Lot No. PROPERTY TAX#: 00439074101100 <br /> (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Broadway Station Apartments TENANT NAME(If Commercial): n/a <br /> OWNER MAILING ADDRESS: sTREE r 17720 15th Ave Ne <br /> Shoreline STMT. WA 7IP 98155 <br /> OWNER PHONE: 2062801484 OWNER EMAIL: 3130broadway@gmail.com <br /> CONTRACTOR NAME: Green Built Northwest <br /> CONTRACTOR ADDRESS: STREET 17720 15th Ave Ne <br /> COY Shoreline STATE WA ZIP <br /> 98155CONTRACTOR PHONE: 2062749226 CONTRACTOR EMAIL: admin@greenbuiltnw.com <br /> CONTRACTOR LICENSE#(REQUIRED): #GREENBN861QE ciry OF EVERETT BUSINESS LICENSE StfREQUIRED) 056746 <br /> PRIMARY CONTACT: DOWNER F CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: <br /> iql \ <br /> CONTACT PHONE: 266_2- 7-4- -IZ2.C <br /> rian ( Ui 6).S(7 <br /> CONTACT EMAIL: q ah,The ,ciaer ilfp pit. co r--) <br /> Existing Use of Building:Apartment BUILDING PERMIT APPLICATION <br /> Contract Price of Work: $ 80000 <br /> vsed Use of Building: no chanoe - apartment Heat Source. giGas 0Electric 00ther <br /> ' .ding Type. OSFR-Detached OSFR-Attached ODuplex ( Multi-Family-#of Units: ; 0Commercial Olndustrial <br /> Type of ProOct. ONew OAddition ORemodel I;21Repair OT.I. OSign OSprinkler ODemolition OChange of Use <br /> DESCRIPTION OF WORK: <br /> Repar rAns I.,r,b woe,.ncsucln,npuldnp Deck wog Rnpagaregonce ertenar deem End recnnillpre.tn,,.lo rm.crt,*carlelSeporme eg,c1r,al.1.1.E.app.e4 k,...D..r,,,..,,,P...**E.r.i..."0..,'4,.^..G,,,,,,,",w..So.,"`...`.. <br /> ,ASSOCIATED BUILDING PERMIT#(if applicable): c'-'.(./C- \\"- C1.\1V.i) <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New Addn Alteration _Repair Type of Project: _New __Addn Alteration Repair <br /> 0 of 0 of N of N of <br /> Fixture <br /> Fixtur List of Fixtures Fixtures List of Fixtures List of Fixtures Fixtures List of Fixtures <br /> es s <br /> NC-Air Handling Units Heat Pump Toilet BackflOw Preventer(Inside Bldg) <br /> Forced Air Systems Unit Heater Bathtub Urinal <br /> Gas Piping ,Boiler Lavatory(Wash Basin) Drinking Fountain <br /> Water Heater Refrigeration Shower Floor Drain <br /> Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap <br /> Gas Range ,Ducting Dishwasher Roof Drains <br /> Clothes Dryer Hookups Other: Clothes Washer Medical Gas <br /> Range Hood Water Heater Other: <br /> Exhaust Fan ' Sink(Service/Bar/Mop/etc.) Other: <br /> SPRINKLER/SUPPRESSION SYSTEM <br /> [Chemical or Water I INo.of Heads <br /> ACKNOWLEDGEMENT-I have reviewed this application and confirm the information contained herein is true end correct Work done pursuant to this permit must comply with <br /> current fedefai.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 /> Buikling 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 /> ---,i comply with The State Contractors Law 18,27 RCW and 298,200,4 WAC <br /> City of Everett Of5cial Use Only <br /> PERMIT <br /> Owner/Authorized Agent Signature Date (Revised 9/2312016) <br />