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MEM PERMIT APPLICATION <br /> • <br /> BUILDING I MECHANICAL/ PLUMBING /SIGN I SPRINKLER/DEMOLITION <br /> EVERETT CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> WASHINGTON (P)425-257-8810 I FAX 425-257-8857 l(E)everetteps@everettwa.gov l www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS:3003 W Casino Road BLDG 40-25 PROPERTY TAX#: <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Boeing Company TENANT BUSINESS NAME(Commercial): Boeing Commerical <br /> OWNER MAILING ADDRESS: STREET 100 North Riverside <br /> CITY Chicago STATE Illinois ZIP 60606 OWNER PHONE: N/A OWNER EMAIL:N/A <br /> CONTRACTOR NAME:Puget Sound Fire Protection Inc <br /> CONTRACTOR ADDRESS: STREET 1429 Ave D#294 <br /> crrY Snohomish STATE WA ZIP 98290 <br /> CONTRACTOR PHONE:(425)252-0065 CONTRACTOR EMAIL:greg@pugetsoundfireprotection.com <br /> CONTRACTOR LICENSE#(REQUIRED):CCPUGETSF889PD CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 53696 <br /> PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:425-252-0065 <br /> Michael Prudnick CONTACT EMAIL:michael@puge reprotection.com <br /> BUILDING INFORMATION <br /> Existing Use of Building:Manufacturing Contract Price of Wo .$5000.00 <br /> Proposed Use of Building:Same Heat Source: DG s ❑Electric DOther <br /> BUILDING USE: DSFR ❑Townhouse IjDuplex ❑ADU ❑Multi-Family-#Units: I ❑✓C mercial ❑Accessory Structure <br /> Type of Project: ❑New ❑ diti ❑Remodel ❑Repair ❑T.I. ❑Sign ❑✓Sprinklkl 'Demolition ❑Change of Use <br /> DESCRIPTION OF WOR . DG 40-25 Ductile Iron Pipe Relocation in Tunnel, Lower Pipe 2' <br /> ASSOCIATED BUILDI ERM 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 List of Fixtures <br /> A/C—Air Handling Units Gas Piping Backflow Preventer(Inside Bldg) Shower,Tub,or Combo <br /> Boiler Gas Range Clothes Washer Sink-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(Residential) Commercial Ventilation Floor Drain Toilet <br /> Exhaust Hood(Type I) (Not Heat/AC system) Hose Bibb Urinal <br /> Exhaust Hood(Type II) Water Heater Interceptor-Grease Waste/Water Piping Repair <br /> Exhaust Hood(Residential) Wood Stove Interceptor-Sand/Oil Water Service(behind meter) <br /> Forced Air Systems Other: Medical Gas Water Valves or Fixtures <br /> Gas Fireplace/Insert/Log Roof Drains Water Heater <br /> SPRINKLER/SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other: <br /> Water Suppression System I A No.of Heads U <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 Official before being authorized under 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, <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 b�C#� \ct0 L co <br /> sty 1 06-05-2019 \ <br /> Owner/A oriz Agent Signature Date (Revised 10/10/2018) <br /> 1/2_, <br />