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PLi1IBING PERMIT APPLICA N -A � - <br /> EVERETT SUBMITTAL INSTRUCTIONS: <br /> OF EVERETT PERMIT SERVICES / ' t 1 <br /> S: Drop off hard copy completed paper application to 3200 Cedar Street 2nd Floor Intake Drop Box. <br /> efASHINGTON CONTACT INFORMATION: (P)425.257.8810 I(E)everetteps@everettwa.gov I(W)everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: STREET 6617 ASSOCIATED BLVD PARCEL#: 28040100303300 <br /> CITY EVERETT STATE WA zip 98203 <br /> SUITE/UNIT#: DSE4 FLOOR#: ADDITIONAL LOCATION INFORMATION: <br /> TENANT/BUSINESS NAME (if non-residential):AMAZON <br /> CONTACT INFORMATION <br /> OWNER NAME:EVERETT COMMERCE CENTER ILP LLC <br /> OWNER MAILING ADDRESS: STREET 600 CALIFORNIA ST SUITE 560 <br /> CITY SAN FRANCISCO STATE CA ZIP 94108 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR COMPANY NAME:ACCO ENGINEERED SYSTEMS <br /> WA STATE CONTRACTOR LICENSE#(REQUIRED):ACCOES1971 DU CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 37887 <br /> CONTRACTOR ADDRESS: STREET 5300 Denver Ave S <br /> CITY Seattle STATE WA ZIP 98108 <br /> CONTRACTOR PHONE:(206) 787-8500 CONTRACTOR EMAIL:wadispatch@accoes.com <br /> PRIMARY CONTACT: ❑OWNER ❑✓ CONTRACTOR ❑ OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:(206) 593-0507 <br /> M ac Kenzie N oyes CONTACT EMAIL:mnoyes@accoes.com <br /> PLUMBING PERMIT INFORMATION <br /> VALUATION OF WORK: $8,000 �Yl LZD 7,5 &l ASSOCIATED PERMIT#(if applicable):62107 � <br /> (Valuation shall include the prevailing fair market value of all labor,materials,and equipment needed to complete the work,whether actually paid or not.) <br /> BUILDING TYPE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑✓Commercial ❑Accessory Structure <br /> DESCRIPTION of WORK: _ Add new natural gas lines to serve rooftop units. *This permit application is for the <br /> natural gas scope only.* <br /> PLUMBING PERMIT FIXTURE COUNT (SCOPE OF WORK) <br /> Fixture Fixture <br /> Count List of Fixtures Count List of Fixtures <br /> (Qty) (QtY) <br /> Backflow Prevention Device(Inside Building)-select devices below: Shower,Tub,or Combo <br /> Fire Service: ❑DCDA, Domestic Service:❑RPBA❑DCVA Commercial Sink(3-compartment,prep,floor) <br /> Clothes Washer Residential Sink(kitchen, bath,bar) <br /> Dishwasher Utility Sink(laundry,mop) <br /> Drinking Fountain Toilet <br /> Floor Drain Urinal <br /> Hose Bibb Waste/Water Pipe Repair <br /> Ice Maker Water Service Line(Behind meter,private side) <br /> Grease Interceptor Water Valves/Fixtures <br /> Sand/Oil Interceptor Water Heater-Electric <br /> Medical Gas Water Heater-Gas <br /> Roof Drains Other(List Type): Natural gas shutoff valve <br /> Sewage Ejector Pump/Sump Pump , Other(List Type): Natural gas pressure raguato, <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 /> City of Everett Official Use Only <br /> PERMIT# <br /> 03/10/2022 1.7 <br /> f 2 03 Jx,U( I n <br /> �Aa1 �� l I �' <br /> ner/ prized Ag Signature Date (Revised 2/8/2021) <br /> 7/3 <br />