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P MI • PERMIT APPLICATIOI <br /> BUILDING / MECHANICAL / PLUMBING / SIGN / SPRINKLER/ DEMOLITION <br /> EVERETT CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> WA$H I N G To N (P)425-257-8810 I FAX 425-257-8857 I (E)everetteps©everettwa.gov I www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS:1325 SE Everett Mall Way PROPERTY TAX#:28051800404900 <br /> LEGAL for new construction: Short Piat/subdivision SEE NEXT PAGE Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: JUMP EVERETT, L.L.C. TENANT BUSINESS NAME(Commercial): <br /> OWNER MAILING ADDRESS: STREET P.O.BOX 1664 <br /> cmf WOODINVILLE STATE WA ZIP 98072 <br /> OWNER PHONE: 206 861 5120 OWNER EMAIL:Phorenst@gmail.com <br /> CONTRACTOR NAME:GAFFNEY CONSTRUCTION <br /> CONTRACTOR ADDRESS: sTREET8105 BROADWAY <br /> ctr' EVERETT STATE WA ZIP 98203 <br /> CONTRACTOR PHONE:425 355 5500 CONTRACTOR EMAIL:tory@gaffneyconstruction.com <br /> CONTRACTOR LICENSE#(REQUIRED): ', Ft i 4. CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): i 7 ii3 <br /> PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR 0 OTHER (Please Specify) ARCHITECT <br /> CONTACT NAME: CONTACT PHONE:206 795 2192 <br /> DOUG HOFIUS, DYKEMAN ARCHITECTS CONTACT EMAIL:dough@dykeman.net <br /> BUILDING INFORMATION <br /> Existing Use of Building:RETAIL Contract Price of Work: $ 1,500,000 <br /> Proposed Use of Building:INDOOR GYM Heat Source: OGas DElectric DOther <br /> BUILDING USE: OSFR ❑Townhouse LiDuplex EADU ❑Multi-Family-#Units: L✓:Commercial EAccessory Structure <br /> Type of Project: ENew i Addition ERemodel ERepair ❑T.I_ ESign ESprinkier EDemolition OChange of Use <br /> DESCRIPTION OF WORK: 48,928 S,F, TENANT IMPROVEMENT FOR CHILDREN!YOIUTH ACTIVITY CENTER WITH <br /> ASSOCIATED CAFE, BAR, FOOD PREPARATION, AND STORAGE SPACES. <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Fixture Fixture Fixture Fixture <br /> Count List of Fixtures count List of Fixtures Count List of Fixtures Count List of Fixtures <br /> /VC—Air Handling Units Gas Piping Backflow Preventer(Inside Bldg) Shower,Tub,or Combo <br /> Boiler Gas Range Clothes Washer Sink-Commercial(3-comp.prep.floor) <br /> . <br /> Clothes Drier Heat Pump&Ductless Dishwasher Sink-Residential(kitchen,bath,bar) <br /> Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility,laundry,mop <br /> Exhaust Fans(Residential) Commercial Ventilatior, Floor Drain Toilet <br /> Exhaust Hood(Type I) (Not Heat/AC system) Hose Bibb Urinal <br /> Exhaust Hood(Type II) Water Heater Interceptor-Grease Waste/Water Piping Repair <br /> Exhaust Hood(Residential) Wood Stove Interceptor-Sand/Oil Water Service(behind meter) <br /> Forced Air Systems Other: Medical Gas Water Valves or Fixtures <br /> Gas Fireplace/Insert/'Log , Roof Drains Water Heater <br /> SPRINKLER! SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other: <br /> Water Suppression System [No.of Heads • <br /> Chemical Suppression System [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,stale.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 296.260A WAC. <br /> City of Everett Official Use Only <br /> PERITle <br /> Owner/Authorized AA Tt Sig!!llnature ( Date (Revised 10/10/2018) <br />