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PERMIT APPLICATION <br /> 112 AK <br /> BUILDING ECHANICAL / PLUMBING / SIGN IMPRINKLER / 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 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS:5901 23RD DR W, EVERETT WA 98203 ,Sre/ I PROPERTY TAX#:01118500000100 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Seaway Corporate Lot 3C TENANT BUSINESS NAME(Commercial): ZAP ENERGY <br /> OWNER MAILING ADDRESS: STREET4932 NE 97th St <br /> cry Seattle STATE WA zip 98115 <br /> OWNER PHONE: 206-734-8430 OWNER EMAIL:felix@zapenergyinc.com <br /> CONTRACTOR NAME:CENTURION HOME SERVICES LLC-Gabe Henderson <br /> CONTRACTOR ADDRESS: STREET 8121 132 PL SE <br /> CITYSNOHOMISH STATE WA zLP 98296 <br /> CONTRACTOR PHONE:425-351-3644 CONTRACTOR EMAIL:centurionhome@yahoo.com <br /> CONTRACTOR LICENSE#(REQUIRED):CENTUHS948MC CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): ' <br /> PRIMARY CONTACT: ❑OWNER D CONTRACTOR CI OTHER(Please Specify) ARCHITECT <br /> CONTACT NAME: CONTACT PHONE:425-260-0413 <br /> KEIR VONDRUSKA CONTACT EMAIL:KVONDRUSKA@KVA-ARCH.COM <br /> BUILDING INFORMATION <br /> i Existing Use of Building:Fl Contract Price of Work: $_ ))2,;50E) p9 <br /> Proposed Use of Building:F1 Heat Source: ❑Gas ❑Electric DOther <br /> BUILDING USE: ESFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ZCommercial ❑Accessory Structure <br /> Type of Project: ❑New Addition ❑Remodel ❑Repair E T.I. Sign Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: NEW NON BEARING WALLS, DOORS AND CEILINGS -ALL INTERIOR SPACE, <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 List of Fixtures <br /> A/C—Air Handling Units Gas Piping _ Backflow Preventer(Inside Bldg) Shower,Tub,or Combo <br /> \_ <br /> Boiler Gas Range Clothes Washer Sink-Commercial(3-comp,prep,floor) <br /> 'Clothes Dryer Heat Pump&Ductless Dishwas7i ...,._ Sink-Residential(kitchen,bath,bar) <br /> 1 Duct Sys Remodel) Refrigeration Drinking Fountain ,- Sink-Utility,laundry,mop <br /> Exhaust Fans(Re ' tial)�'Commercial Ventilatior Floor Drain Toilet <br /> Exhaust Hood(Type I1_.____.(Not Heat/AC system) Hose Bibb Urinal <br /> Exhaust Hood(Type II) Wate?Heater__ Interceptor-Grease- —Waste/Water Piping Repair <br /> Exhaust Hood-'(Residential) Wood Stove - -, Interceptor Sand/Oil Water Service(behind meter) <br /> Forced lkir Systems Other: Medical`Gas Water Valves or Fikttrres,. <br /> Gas-fireplace/InserULog Roof Drains Water Heater <br /> ,,,:'.- <br /> SPRINKLER/ SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other: <br /> Water Suppression System No.of Heads <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 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 /> Keir Vondruska .a,�w ..m,.�.o�..w�..cr,a.�a 12-28-2020 P � ��\� O,� <br /> Owner/Authorized Agent Signature Date (Revised 10/10/2018) / <br /> //' <br />