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•47T PERMIT APPLICATION • <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 — /ALL. (attach copy of long legal description) <br /> C NTACT 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:Dahlgrell Industrial <br /> CONTRACTOR ADDRESS: STREET <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE:206-719-6198 CONTRACTOR EMAIL:garrettj©dahlgrenindustrial.com <br /> CONTRACTOR LICENSE#(REQUIRED):DAHLGI*813MH CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 61202 <br /> PRIMARY CONTACT: EI OWNER 0 CONTRACTOR 0 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: $370,000 <br /> Proposed Use of Building:Manuacturing Heat Source: DGas ❑Electric ❑Other _ <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex DMulti-Family-#of Units: ❑Commercial Xilndustrial <br /> Type of Project: :New DAddition DRemodel DRepair ®T.I. ❑Sign ❑Sprinkler '❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: <br /> Remove and disposal of existing concrete slab and foundation. Install new slab, foundation, andd utility trench. <br /> ASSOCIATED BUILDING PERMIT#(if applicable): ` -0-7 ek <br /> jr- <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 I 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 WAG, <br /> City of Everett Official Use Only <br /> PEZT#.2.1 <br /> —77(72 0 2 / OC CO <br /> Owner/Authorized Agent Signature Date (Revised 10/12/2015) <br /> I/_ <br />