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014177- IIIII PERMIT APPLICATION <br /> BUILDING / MECHANICAL/ PLUMBING I SIGN /SPRINKLER I DEMOLITION <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 /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: 3711 Smith Avenue PROPERTY TAX#: 00576001900001 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Everett Gospel Mission TENANT BUSINESS NAME(Commercial): <br /> OWNER MAILING ADDRESS: STREET PO Box 423 <br /> CITY Everett STATE WA ZIP 98206 <br /> OWNER PHONE: (425) 740.2500 OWNER EMAIL: JHUII Q©EGMission.org <br /> CONTRACTOR NAME: Gaffney Construction <br /> CONTRACTOR ADDRESS: STREET 8105 Broadway <br /> CITY Everett STATE WA ZIP 98203 <br /> CONTRACTOR PHONE: (425) 355.5500 CONTRACTOR EMAIL: joe@gaffneyconstruction.com <br /> CONTRACTOR LICENSE#(REQUIRED): GAFFNCI104K3 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): <br /> PRIMARY CONTACT: 0 OWNER ❑CONTRACTOR ❑OTHER(Please Specify) Architect <br /> CONTACT NAME: CONTACT PHONE: (206) 920.3554 <br /> Phil Frisk CONTACT EMAIL: Phil.Frisk@PWFArchitecture.com <br /> BUILDING INFORMATION /n <br /> Existing Use of Building: Homeless shelter Contract Price of Work: $, _ 7 it/0� OQ 0. <br /> Proposed Use of Building: Homeless shelter Heat Source: EGas ❑Electric ❑Other _ <br /> BUILDING USE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ✓❑Commercial ❑Accessory Structure <br /> Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑✓T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: Reconfiguring the top floor of an existing homeless shelter to accommodate a new laundry room, 4 <br /> new exam room, and expanded kitchen. Total number of overnight residents reduced from 83 tope No work proposed <br /> outside or elsewhere in the building. 7 p <br /> ASSOCIATED BUILDING PERMIT#(if applicable): Original building permit approved around 1992. <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Fixture Fixture Fixture Fixture E <br /> Count List of Fixtures Count List of Fixtures Count List of Fixtures Count List of Fixtures <br /> ...] <br /> A/C—Air Handling Units Gas Piping <br /> � Backflow Preventer(Inside Bldg) Shower,Tub,or Combo <br /> Boiler Gas-Range 3 Clothes Washer Sink-Commercial(3-comp,prep,floor) <br /> 3 Clothes Dryer Heat Pump&Ductless 1 Dishwasher 2 Sink-Residential(kitchen,bath,bar) <br /> Duct System(Remode)A C./7 Refrigeration 2 Drinking Fountain 1 Sink-Utility,laundry,mop <br /> 2 Exhaust Fans hLaf'f Commercial Ventilation 1 Floor Drain Toilet <br /> Exhaust Hoo 9-t) (Not Heat/AC system) Hose Bibb J, Urinal <br /> Exhaus\H� (hype II) Water Heater Interceptor-G se � � Waste/Water Piping Repair <br /> 1 Exhaust 61d(Residential) Wood Stove Interceptor-Sa� Water Service(behind meter) <br /> Forced4(ir Systems Other: Medical Gas / Water Valves or Fixtures <br /> Ggs'Fireplace/Insert/Log Roof Drains. Water Heater <br /> ?SPRINKLER/ SUPPRESSION SYSTEM Se,ge4jector 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,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 Offic efore 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 corn y wit the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> r.)1 4 /4 PERMIT# <br /> r t (/• <br /> . 2/4/19 (6(01^(2 -7 I <br /> Oven /Authoriz Agent Signature Date (Revised 10/10/2018) <br /> k- <br />