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PERMIT APPLICATION
<br /> {.72,11.E12:IG I i7LECI4ANICAL/PLUMBING I SIGN I SPREMKLER I DEMOLMOM
<br /> CITY OF EVERETT PERMIT SERVICES
<br /> 3200 CEDAR STREET,EVERETT,WA 93201
<br /> (?)425-257-8S'.0 : FAX 425-257-8857 !(E)everetteps@everettm.gov 1 ',•.-...w.everettwa.cov/pG,.rrnits
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<br /> CCSEE z-,,-_-;-_-_,T,,,,Ess: 4727 Evergreen.1.A!2.1, :----Rc.2=77"7::;: .:, 04073C1700300 ,
<br /> ,....:70.:::_roc n::,...cc uct:on: Short Pt-at/subdivision LOT -: 07:-. BSP REQAS:`:0
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<br /> Penguin Properties LLC TENANT NA.':-.E'',:,7 Corci :MUSiC&Right Chi ens Acaderr(
<br /> c•:-,:;,:ER::,.:.:E.ING ADDRESS: STREET 2931 Rucker Avenue
<br /> me Everett TATE WA ZCP 98201
<br /> ;OWNER PHONE: OWNER EMAR_:
<br /> CONTRACTOR NAME:
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<br /> !CONTRACTOR ADDRESS: STREET
<br /> iC{TY STATE SW
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<br /> i!CONTRACTOR PHONE: CONTRACTOR EMAIL:
<br /> ,iCONTRACTOR LICENSE (REQUIRED): CrlY CrTF--7---, BUSINESS t.tNSE G(REQUIRED):
<br /> 'PRIMARY CONTACT: DOWNER 0 CONTRACTOR 0 OTHER(. ease Specify)
<br /> lriCONTACT NAME:,e2kTPe nigrEvoSYIV-4/. CONTA, PHON-. '2...c.".- 377 Q 2-2_
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<br /> ,Existing Use of Building: Ret Store onlract Price of lAfork:$ I"7'2 00(.2
<br /> Proposed Use of Building: Child Care , iiii A
<br /> All Heat Source: CY-Gas OBectric Daher
<br /> [Building Type: 0 SFR-Detached OSFR-Attachec:: De go,- ONIutti-Family4 of Units: CECcxnrnercial 0Industrial
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<br /> iTyce of Project: ONew 0Addition NRemodel ' ' : it T.I.DOSign 0Sprinkler 0Deirtotition ESICharige of Use
<br /> i,DESCR'IPTION OF WORK:
<br /> Tenant Improvement Alterations to exi7 • 6 ',ding. Work includes adding fire protection sprinkler system and
<br /> il constructing partitions.
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<br /> Assoc : :1;',..;::::NG PEE7,',L.-.7: (r:'
<br /> 'Type of Project: New Addn X,Alt .i-. Repair ! Type of Protect: Nev: Addn AAlteration R .,atr
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<br /> Fixtures of# ,, oaf
<br /> List of Fixturesof List of Fixtures List of Fixturesures xtures List&Factures
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<br /> NC—Air Handling Units : Heat Pump Toilet Backflow Preventer(Inside Bldg)
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<br /> Forced Air Systems r Unit Heater Bathtub Urinal
<br /> ' ,Gas Piping Boiler ', 2 Lavatory(Wash Basin) Drinking Fountain ,
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<br /> Water Heater Refrigeration t '' Shower Floor Drain
<br /> Gas Fireplace Wood Stove l Kitchen Sink&Disposal Grease Trap
<br /> Gas Range Ducting i Dishwasher Roof Drains i
<br /> !Clothes Dryer Hookups Other: r , Clothes Washer Medical Gas
<br /> i. !Range Hood Water Heater ! Other:
<br /> Exhaust Fan : : 3 Sink(ServiceJBarItufopietc..) Other:
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<br /> SPRI :i....ER; SU;C2-:72,!:::?.EISS3::CT.:_'
<br /> g to be determined!Number ci He.ats i I
<br /> AC,KNOWLEDGE(ZENT:.'hcvo.reviewed th.'s.2c..7.:: t.c.n ..::-.•ti co:7f:rr,-;Ins inrcrrn=n ce.q:a;ned lx•rein is:','L..;:.,::,-.:..'co-Teo.t.Work done.p.u.z-Lcnt to t7..r,permit inns
<br /> current federal,state,end:coal taw.The granting of,2 porrte only authorizes approved vior;,:and no C.--'''' '""`:i'^"C`:',::-1. '''''' "'IS must fyrV be authorized in writing from the
<br /> Building Othdal before being authorized under any circumstance.I am the owner,or!am authorized:5; :V-72(3'.'.77 '0.,1"., ,;-:.:,•p:.,.srt.;.•to perform the work for which appfscation is made,
<br /> and!comply with the State Contractors Law Te.27 RCW and 296.203A WAC.
<br /> City of E-vered Off..-iat Use Only
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<br /> ,c,,, •s„,tilta..) (jolt., 7—c-,2
<br /> OVenet-rAuthorizlAnent Signature Date (Revised 52012016)
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