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PERMIT APPLICATION <br /> BUILDING / MECHANICAL/ PLUMBING /SIGN / SPRINKLER/ DEMOLITION <br /> 1W 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 /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: 333 Smith Island Road, Everett WA 98201 PROPERTY TAX#: 29051600300800 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: City of Everett TENANT NAME(If Commercial): Everett Animal Shelter <br /> OWNER MAILING ADDRESS: STREET 3002 Wetmore Avenue <br /> CITY Everett STATE WA zIP 98201 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: Auburn Mechanical <br /> CONTRACTOR ADDRESS: STREET 2623 West Valley Hwy N <br /> CITY Auburn STATE WA ZIP 98071 <br /> CONTRACTOR PHONE: 253-838-9780 CONTRACTOR EMAIL: aleks@auburnmechanical.com <br /> CONTRACTOR LICENSE#(REQUIRED): AUBURNM116313A CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): <br /> PRIMARY CONTACT: ❑OWNER CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: Aleks Kazadayev CONTACT PHONE: 206-730-1198 <br /> CONTACT EMAIL: aleks@auburnmechanical.com <br /> 1301E©ING pNIT APPLICATION <br /> Existing Use of Building: Senior Center Contract Price of Work: $ 7,100 <br /> Proposed Use of Building: Unchanged from above Heat Source: []Gas []Electric ❑Other <br /> Buildin Type: ❑SFR-Detached ❑SFR-Attached ❑Du lex ❑Multi-Family-#of Units: vtornmercial ❑Industrial <br /> Type of Project: []New ❑Addition ❑Remodel ❑Repair l ❑Sin ❑Sprinkler ❑Demolition ❑Chan e of Use <br /> DESCRIPTION OF WORK: Install new drinking fountain and new outlet box for laundry <br /> machine <br /> ASSOCIATED BUILDING PERMIT# if applicable): <br /> MECHANIGAI PRRMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New Addn _Alteration _Repair Type of Project: _New _Addn VAIteration _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) 1 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: 1 Clothes Washer Medical Gas <br /> Range Hood Water Heater Other:Point of use el.water heater <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 1 am authorized by the owner of this property to perform the work for which application is made, <br /> and l comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> PERMIT# ' 1 _ <br /> 4/5/17 � n <br /> l�Il <br /> S.E 4® a <br /> .�j r.�%� L.:Dp�M4`I 15150 -�'Ma Fvavn <br /> Owner/Authorized Agent Signature Date (Revised 5/20/2016) <br />