Laserfiche WebLink
PERMIT APPLICATIO <br /> BUILDIN ECHANICAL/ PLUMBING/SIGNORINKLER/ DEMOLITION <br /> EVERETT CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> WASHINGTON (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:10411 AIRPORT ROAD,SUITE 102 PROPERTY TAX#:01036300010200 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: ROSEN HARBOTTLE-AMY LIN TENANT BUSINESS NAME(Commercial): DUNN LUMBER <br /> OWNER MAILING ADDRESS: STREET 1800 112TH AVE NE SUITE 310 <br /> qTy BELLEVUE STATE WA zip 98004 <br /> OWNER PHONE: 425-289-2234 OWNER EMAIL:amyl@rosenharbottle.com <br /> CONTRACTOR NAME:TBD � b �01A., C <br /> CONTRACTOR ADDRESS: STREET <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> CONTRACTOR LICENSE#(REQUIRED 6C CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): L4CCC,,C9 <br /> PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR D OTHER(Please Specify) WARE MALCOMB ARCHITECTS <br /> CONTACT NAME: CONTACT PHONE:206-778-8703 <br /> JONI STOKDIJK CONTACT EMAIL:jstokdijk@waremalcomb.com <br /> -BUILDING INFORMATION <br /> Existing Use of Building:B5-1 Contract Price of Work:$70,000 <br /> Proposed Use of Building:B/S-1 Heat Source: ❑Gas DElectric ❑Other <br /> BUILDING USE: ❑SFR ['Townhouse ['Duplex ❑ADU ❑Multi-Family-#Units: ❑✓Commercial DAccessory Structure <br /> Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ✓❑T.I. ❑Sign OSprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: THE SCOPE OF THIS PROJECT IS A SECOND GENERATION TENANT IMPROVEMENT OF <br /> EXISTING OFFICE&STORAGE SPACE FOR USE OF THE SAME. SCOPE OF WORK INCLUDES THE LEVEL 1 OFFICE <br /> AREA WHICH INCLUDES CEILING DEMO. NEW CONSTRUCTION TO INCLUDE PARTITIONS, DOORS, LIGHTING&FINISH <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION " <br /> Fixture Fixture <br /> Fixture <br /> List of Fixtures Fixture List of Fixtures CouCount List of Fixtures Count List of Fixtures <br /> A/C—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 /> Clothes Dryer 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 Ventilation 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 1 SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other. <br /> Water Suppression System No.of Heads <br /> Chemical Suppression System 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.lam the owner,or 1 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 Official Only <br /> ../ 1V 3 , PERMIT �Everett I I D�Use� <br /> Owner/, oriz:'. Ager'Signatu : Date (Revised 10/10/2018) <br /> ) <br />