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PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS: PROPERTY tax# P MIT# <br /> 800° Evergreen Way 280413001033001 (003 -0,09 <br /> LEGAL for new construction: Short Platisubdivision----------------—Lot No------ (attach copy of long legal description) <br /> OWNER CHIC of Snohomish County Phone/E-mail 425-78q-3700 <br /> Address P.O. Box 13000 City/Stateizip Everett, NA CIKOG <br /> APPLICANT: _—Owner X_Owner's Agent -__Contractor --Contractor __s Agent -Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR 1/v L&I Lic.# COE Bus. Lic.#Q b <br /> Address ;11U <br /> IPhone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT Janet Onda <br /> cmmunity 14eolth Center of Snohomish County <br /> Phone/E-mail 425-823-2244 Janet@aLuerks.com <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 180 000_ <br /> Existing Use of Building Of f ICe_BUllding------------------------- HEAT SOURCE: <br /> Proposed Use of Building Off ICe BUlldIng_____ Gas Electric Other <br /> Building type: ___Single Family ___ Duplex___Townhouse ___Multi-Family X_Commercial <br /> Type of project: ---New ___Addition Remodel ___Repair_-X T.I.___Sign-_-Sprinkler_ Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> THE PROJECT CONSISTS OF RENOVATIONS TO AN EXISTING OFFICE BUILDING. ONCRETE STAIR <br /> CONNECTING EXISTING PARKING LOTS. INTERIOR RENOVATIONS TO INCLUDE REMOVAL OF NON-BEARING STUD WALL PARTITIONS AND REPLACEMENT WITH NEW <br /> NON-BEARING STUD WALL PARTITIONS, GYP. WALLBOARD, CEILING SYSTEMS, SELECT FLOOR FINISHES, AND LIGHTING. MODIFICATIONS AND NEW ROUGH IN FOR <br /> ELECTRICAL, MECHANICAL, AND PLUMBING SYSTEMS AS REQUIRED FOR NEW CONFIGURATION. IN ADDITION, MODIFICATIONS TO TLE FIRE-LIFE SAFETY AND FIRE <br /> SUPPRESSION SYSTEMS AS REQUIRED PER NEW ROOM CONFIGURATIONS. <br /> ssELECTRICAL, MECHANICAL, PLUMBING, FIRE-LIFE SAFETY AND FIRE SUPPRESSION SYSTEMS TO BE BIDDER DESIGNED. <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: ---New---Addn ___Alteration___Repair Type of Project: _New___Addn ___Alteration__Repair <br /> Show Number(#)of fixtures Show Number(#)of Fixtures <br /> A/C-air handling units Toilet <br /> Forced airs stems Bathtub <br /> Gas piping Lavatory wash basin) <br /> Water heater Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer Clothes washer <br /> j Range hood Water heater <br /> Exhaust fan Sink(service/bar/mop/etc.) <br /> Heat pump Backflow preventer <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> Ducting Roof drains <br /> Other_________-------- Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> Number of Heads Other: <br /> I hereby certify that I have read and examined this application and know the same to be true and correct All provisions of laws and ordinances governing this type of work will be complied <br /> with whether specifed herein or not.The granting of a permit does not presume to give authority to violate or cancel the provision of any other state or local law regulating construction <br /> That I am authorized by the owner of this property to perform the work for which application is made and I comply with the Slate Contractors Law 18.27 RCW and 296 200A WAC. <br /> Owne Aut orized Agent Signature Date / (Revised 6/2012) <br />