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PERMIT APPLICATION <br /> BUILDING /MECHANICAL/ PLUMBING/SIGN /SPRINKLER/ 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:426 East Casino Road PROPERTY TAX#:28051800202300 <br /> SEE <br /> LEGAL for new construction: Short Plat/subdivision Lot No?crt1\c-'-\(attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: 426 E Casino Rd, LLC TENANT BUSINESS NAME(Commercial): <br /> OWNER MAILING ADDRESS: STREET 10p — 71=k S,\D. , 5,A.,-TE-4 po <br /> crry Washington STATE DC ZIP 20005 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME:Pioneer Construction Services, Inc. <br /> CONTRACTOR ADDRESS: STREET 12014-20th Street S.E. <br /> c,n, Lake Stevens STATE WA DP 98258 <br /> CONTRACTOR PHONE:(425) 508-2852 CONTRACTOR EMAIL:jim@pioneerconstructionservices.c <br /> CONTRACTOR LICENSE#(REQUIRED):P CITY OF EVERETT BUSINESS LICENSE#(REQ ED):(V 19C7C1 <br /> PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR 0 OTHER(Please Specify) ✓ <br /> CONTACT NAME: CONTACT PHONE: (,� <br /> A 1 M TAU C2j t CONTACT EMAIL:cVk w\Q_0\Dv-\e n"hracif le--ES.cm v✓m <br /> BUILDING INFORMATION <br /> Existing Use of Building:Office Contract Price of Work:$ <br /> Proposed Use of Building:No changes Heat Source: ❑Gas ❑Electric ❑Other <br /> BUILDING USE: ❑SFR ETownhouse ❑Duplex ❑ADU ❑Multi Family-#Units: ❑✓Commercial ❑Accessory Structure <br /> Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.l. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: Installation of new satellite and associated cradle on roof of existing 5-story office building. <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION/ <br /> Fixture Fixture Fixture Fixture <br /> Count List of Fixtures Count List of fixtures Count List of Fixtures Count st of Fixtures <br /> NC—Air Handling Units G iping Backflow Preventer(Inside Bldg) Sh• -r,Tub,or Combo <br /> Boiler as Range Clothes Washer :ink-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(Residentia Commercial Ventilatior Floor Drain Toilet <br /> Exhaust Hood(Type I (Not Heat/AC system) Hose Bibb Urinal <br /> Exhaust Hood(Ty II) Water Heater _Interceptor-Grease Waste/Water Piping Repair <br /> Exhaust Hood esidential) Wood Stove Interceptor-San. Water Service(behind meter) <br /> Forced Air stems Other: Medical G.: Water Valves or Fixtures <br /> Gas Fir ace/Insert/Log Roof Drains Water Heater <br /> SPRI LER/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.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 /> r. City of Everett Official Use Only <br /> I0-0 <br /> PERMIT �� <br /> 0 ner/ uthorized Agent Signature Date (Revised 10/10/2018) <br />