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• PERMIT APPLICATION <br /> • <br /> BUILDING / MECHANICAL / PLUMBING / SIGN / SPRINKLER/ DEMOLITION <br /> /11.1k/ //---A CITY OF EVERETT PERMIT SERVICES <br /> 44110 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: From- © 14th St. to` 1520 W Marine View Dr: PROPERTY TAX#: <br /> LEGAL for new construction: Short Plat/subdivision •A0J LA G'f Ua(4Lq{)4 ,A4 (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Port of Everett TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 1205 Craftsman Way, Suite 200 <br /> cry Everett STATE WA ZIP 98201 <br /> OWNER PHONE: 425-259-3164 OWNER EMAIL: <br /> CONTRACTOR NAMg1. 1iler 1 1 1/U",Y I tam � I t <br /> CONTRACTOR ADDRESS: STREET <br /> CITY STATE tAJ7� ZIP*Lt <br /> CONTRACTOR PHONI "L �Q, CONTRACTOR EMAIL: VVV"'���11rr✓\\\ <br /> CONTRACTOR LICENSE#(REQUIRED): (A t((_ CITY OF EVERETT BUSINESS LICENSE#(REQUIRED) I�( <br /> PRIMARY CONTACT: p OWNER 0 CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 425-388-0613 <br /> Brandon Whitaker CONTACT EMAIL: bwhitakeriportofeverett.com <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: Contract Price of Work:$ 2;11.— ✓e1— <br /> Proposed Use of Building:Gangway attachment to existing wooden wharf 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 ID Repair ❑T.l. ❑Sign ❑Sprinkler ❑Demolition OChange of Use <br /> DESCRIPTION OF WORK: <br /> The Port is implementing an in-water project in the Central Marina:upgrading facilities,utilities with new docks,maintenance dredging,and realignment of existing dock. <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 #°f List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <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 1 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 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 /> City of Everett Official Use Only <br /> PERMIT.# <br /> Zr%0 •--7/i.'Gld _Fc2 eo tr or eve - 30-1� �.� i, i 16 0- <br /> Owner/Authorized Agent Signature Date (Revised 9/23/2016) <br /> 1� <br />