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OLTPERMIT APPLICATIC <br /> BUILDIN_. i MECHANICAL / PLUMBING / SIGN 1 L PRINKLER / DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 1 (E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS:6200 23rd Drive W. Everett Wa 98203 PROPERTY TAX#: 022804-3-001-0005 <br /> LEGAL for new construction: Short Plat/subdivision__ Seaway Center -Lot No. 4A (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Seaway Lot4A LLC TENANT NAME (If Commercial): Walter Dorwin Teague and Associates <br /> OWNER MAILING ADDRESS: STREET 2025 1ST AVE, STE 1130 <br /> ci,-,, Seattle STATE WA zip 98121 <br /> OWNER PHONE: (206) 448-1818 OWNER EMAIL: frontdesk@fksdo.com <br /> CONTRACTOR NAME GLY Construction Inc <br /> CONTRACTOR ADDRESS: STREET 200 112th Ave NE #300 <br /> CITYBellevueSTATE WA , , 98004 <br /> CONTRACTOR PHONE: 425-451-8877 CONTRACTOR EMAIL: christian.hand@gly.com <br /> CONTRACTOR LICENSE#(REQUIRED): GLYCOI*01809 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 021502 <br /> PRIMARY CONTACT: 0 OWNER ® CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: <br /> Christian Hand CONTACT PHONE: 206-406-0973 <br /> CONTACT EMAIL: christian.hand@gly.com <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: M-1 Contract Price of Work: $ 39,538 <br /> Proposed Use of Building: M-1 Heat Source: ®Gas DElectric ❑Other <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: DCommercial ®Industrial <br /> Type of Project: ❑New DAddition ❑Remodel DRepair ❑T.I. DSign ❑Sprinkler MDemolition ❑Change of Use <br /> DESCRIPTION OF WORK: Demolition of existing architectural finishes; mechanical, electrical, and plumbing systems <br /> supporting the 1500sf "Fuel Cell Lab". Finishes to be removed include GWB walls, doors and <br /> frames, flooring and ceiling finishes. <br /> ASSOCIATED BUILDING PERMIT#(if applicable): NA I <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: New Addn Alteration Repair Type of Project: New Addn _Alteration Repair <br /> #of I #of <br /> List of Fixtures #of List of Fixtures #of List of Fixtures 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 pemiit 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 /> ; -, 1/28/2016 PERMIT# A I <br /> Owner/Authorized Agent Signature Date (Revised 10/12/2015) 1 <br />