Laserfiche WebLink
41477- • PERMIT APPLICATION <br /> BUILDING I MECHANICAL / PLUMBING / SIGN / SPRINKLER / DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES "z.N.b F I tYV <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 /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: 7710 Evergreen Way, Everett WA 98203 PROPERTY TAX#: 28050700300300 <br /> LEGAL for new construction. Short Plat/subdivision Lot No._ (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: LANE PROPERTIES LLC TENANT NAME(If Commercial): FELLOWSHIP CHRISTIAN SCHOOL <br /> OWNER MAILING ADDRESS: STREET 10515 EVERGREEN WAY <br /> CITY EVERETT STATE WA ZIP 98204 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME EMERALD FIRE <br /> CONTRACTOR ADDRESS: STREET 11021 CRAMER ROAD KPN <br /> CITY GIG HARBOR STATE WA zip 98329 <br /> CONTRACTOR PHONE: 253-857-2056 CONTRACTOR EMAIL: ANGIEV©EMERALDFIRELLC.COM <br /> CONTRACTOR LICENSE#(REQUIRED): EMERAFL980MR CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 43979 <br /> PRIMARY CONTACT: 0 OWNER ,7 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 253-857-2056 <br /> ANGIE VOELPEL / KEITH HILLSTROM CONTACT EMAIL: ANGIEV@EMERALDFIRELLC.COM <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: •Contract Price of Work: $ 94, 007.00 <br /> Proposed Use of Building. Heat Source: ❑Gas DElectric DOther <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: VCommercial ❑Industrial <br /> Type of Project: ZNew DAddition DRemodel DRepair ❑T.I. ❑Sign cilSprinkler ❑Demolition DChange of Use <br /> DESCRIPTION OF WORK: <br /> Install new fire sprinkler system & riser in the existing building. • <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: /New _ Addn Alteration Repair Type of Project: New Addn Alteration Repair <br /> #of List of Fixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> A/C—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 o ater I30 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. 1 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 /> �t1 City of Everett Official Use Only <br /> X�oncpi <br /> '�� Ig PERMtosos 6 <br /> ner/Autho d Agent Signature Date (Revised 9/23/2016) <br /> ZW <br />