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477- 0 PERMIT APPLICATIOP <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 /> PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: 3003 W Casino Rd. PROPERTY TAX#: 28041000100200 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Boeing Co TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET PO Box 3707 M/S OH-13 <br /> CITY Seattle STATE WA ZIP 98124-2207 <br /> OWNER PHONE: 425-260-2668 OWNER EMAIL: todd.j.haberlack@boeing.com <br /> CONTRACTOR NAME'. NSA t {�q ( \A d,i& }- i r - <br /> CONTRACTOR ADDRESS: STREET <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: L CONTRACTOR EMAIL: <br /> CONTRACTOR LICENSE#(REQUIRED):gA-I L_ if g 13 N► rY CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): to I L.0?i <br /> PRIMARY CONTACT: NI OWNER 0 CONTRACTOR ❑ OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 425-260-2668 <br /> Todd Haberlack 'CONTACT EMAIL: todd.j.haberlack@boeing.com <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: N/A Contract Price of Work: $750,000 <br /> Proposed Use of Building: Heat Source: ❑Gas ❑Electric DOther <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: DCommercial l2fIndustrial <br /> Type of Project: ❑New ❑Addition ❑Remodel DRepair IIT.I. OSign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: Install Trenches and Necessary Utilities to Support Ultra Sonic Knife(USK)Machines 1&5 <br /> o Provide 4'wide X 2'deep X 186'long utilidor trench. <br /> o Provide finger trenches to operator station <br /> o Provide trenching construction tent during construction. <br /> o Provide a 4'8'printer table. <br /> o Provide and install four bollards at south end to protect cabinets. <br /> o Provide Trenching construction tent 9'to 15.clearance required. <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: New Addn Alteration _Repair Type of Project: New _Addn _Alteration Repair <br /> #of List of Fixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> A/C—Air Handling Units Heat Pump Toilet _Backflow Preventer(Inside Bldg) <br /> Forced Air Systems Unit Heater Bathtub _Urinal <br /> •Gas Piping Boiler Lavatory(Wash Basin) Drinking Fountain <br /> _Water Heater Refrigeration Shower _ Floor Drain <br /> Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap <br /> Gas Range Ducting Dishwasher Roof Drains <br /> Clothes Dryer Hookups Other: Clothes Washer Medical Gas <br /> Range Hood Water Heater Other: <br /> Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: <br /> SPRINKLER/ SUPPRESSION SYSTEM <br /> Number 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 /> City of Everett Official Use Only <br /> 0/ PERMIT# <br /> ,l / (/O ZZ F 2`Z() Co ' tL 3� <br /> Owner/Authorized Ag t Signature Date (Revised 10/12/2015) <br /> v Z <br />