11400 EVERGREEN WAY 2022-06-28 - Laserfiche WebLink

PERMIT APPLICATION BUILDING / MECHANICAL / PLUMBING / SIGN /SPRINKLER ! DEMOLITION EVERETT CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 WASHINGTON (P)425-257-8810 I FAX 425-257-8857 I (E)everetteps@everettwa.gov I www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS:11400 WA- 9 Smars 4 ctel .0 t •R•..ERTY TAX#:00442900401402 LEGAL for new construction: Short Plat/subdivision Lot No. (- tach copy of long legal description) CONTACT INFORMATION OWNER NAME: Wal-Mart Real Estate Business Trust TENANT BUSINESS NAME(Commercial): Electrify America OWNER MAILING ADDRESS: STREET2001 SE 10th Street crTY Bentonville STATE AR zip 72716 OWNER PHONE: ( ' 1 OWNER- EMAIL: CONTRACTOR NAME: TBD I/ FYI ' v O4 1/v' l iOn (Tt LL(j CONTRACTOR ADDRESS: STREET £2 ' �V , VIA, I v ti 3 CITY \AV I tAM/V v STATE krit ZIP 6 VO(4)5. CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): SIA,VY\ \ I, :Ai CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): ' 4 - PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR ❑OTHER(Please Specify) Black&Veatch for Electrify America CONTACT NAME: CONTACT PHONE: 913-458-6725 Christina Suarez CONTACT EMAIL: suarezc .co BUILDING INFORMATION Existing Use of Building:NA Contract Price o ork: $10000 Proposed Use of Building:NA Heat Source: ,LIGas ❑Electric, ❑Other NA BUILDING USE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units.` LJCoiT(mercial ❑Accessory Structure Type of Project: ❑New ❑Addition ❑Remodel ❑Repair LTA. ❑✓Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: Upgrade Electrical Equipment (3) 175KW Signet GEN 3 Power Units; (3) 175KW Signet GEN 3 Dispen Estall (1) (N) light pole: Install (3) (N) EV parking signs; remove/replace portion of concrete pad &trex fence ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Fixture Fixture Fixture Fixture Count List of Fixtures Count List of Fixtures Count List of Fixtures Count List of Fixtures A/C—Air Handling Units Gas Piping Backflow Preventer(Inside Bldg) Shower,Tub,or Combo Boiler Gas Range Clothes Washer Sink-Commercial(3-comp,prep,floor) Clothes Dryer Heat Pump&Ductless Dishwasher Sink-Residential(kitchen,bath,bar) Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility,laundry,mop Exhaust Fans(Residential) Commercial Ventilation Floor Drain Toilet Exhaust Hood(Type I) (Not Heat/AC system) Hose Bibb Urinal Exhaust Hood(Type II) Water Heater Interceptor-Grease Waste/Water Piping Repair Exhaust Hood(Residential) Wood Stove Interceptor-Sand/Oil Water Service(behind meter) Forced Air Systems Other: 'Medical Gas Water Valves or Fixtures Gas Fireplace/Insert/Log Roof Drains Water Heater SPRINKLER/ SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other: Water Suppression System No.of Heads Chemical Suppression System No.of Heads ACKNOWLEDGEMENT:1 have reviewed this application and confirm the information contained herein is true and correct. Work done pursuant to this permit must comply with 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 Building Official before being authorized u der any circumstance.I am the owner,or 1 am authorized by the owner of this property to perform the work for which application is made, and I comply with the State Contracto Law/1 .27 RCW W200A WAC. City of Everett Official Use Only PERM Christina Suarez Digitally signed by Christ'a Suarez 7/6/20 V 2 3 Dale:2020.07.0611:39: -07'00' (( Owner/Authorized Agent Signature Date (Revised 0/2018)