830 80TH ST SW RENU MEDICAL 2023-08-01

OLT PERMIT APPLICATION. BUILDING / MECHANICAL/ PLUMBING /SIGN /SPRINKLER/ DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 (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: 830 80th SW PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: Renu TENANT NAME(If Commercial): Renu OWNER MAILING ADDRESS: STREET 830 80th SW crry Everett STATE WA ZIP OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: TubeArt CONTRACTOR ADDRESS: STREET 11715 Se 5th St cmTv Bellevue STATE WA ZIP 98005 CONTRACTOR PHONE: 206 679 8732 CONTRACTOR EMAIL: shawnb@tubeart.com i� 1693 CONTRACTOR LICENSE#(REQUIRED): TUBEDA*311 QS CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): kerb PRIMARY CONTACT: OWNER 17 CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 206 679 8732 Shawn Bowen CONTACT EMAIL: shawnb©tubeart.com BUILDING PERMIT APPLICATION Existing Use of Building: Contract Price of Work:$ 3500.00 Proposed Use of Building: Heat Source: ❑Gas ❑Electric ❑Other Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial Dlndustrial Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. VSign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: install one wall sign ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Type of Project: _New _ Addn Alteration _Repair Type of Project: _New Addn _Alteration _Repair #of List of Fixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures Fixtures Fixtures Fixtures Fixtures A/C—Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) Forced Air Systems Unit Heater Bathtub Urinal Gas Piping Boiler Lavatory(Wash Basin) Drinking Fountain Water Heater Refrigeration Shower Floor Drain Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap Gas Range Ducting Dishwasher Roof Drains __ Clothes Dryer Hookups Other: Clothes Washer Medical Gas Range Hood Water Heater Other: Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: SPRINKLER/SUPPRESSION SYSTEM Chemical or Water No. of Heads 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 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 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, and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIgz r O Shawn Bowen 8/5/2020 Owner/Authorized Agent Signature Date (Revised 9/23/2016) /7.