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PERMIT APPLICATIOI <br /> - / <br /> BUILDIN MECHANICAL/ PLUMBING /SIGN / PRINKLER/ DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 l FAX 425-257-8857 1(E)everetteps@everettwa.gov l www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: 6301 36th Ave W PROPERTY TAX#: 28040300400800 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Panattonl Development Inc TENANT NAME(If Commercial): Byfam Healthcare <br /> OWNER MAILING ADDRESS: STREET 6840 Fort Dent Way, Suite 350 <br /> ciTY Seattle STATE WA zip 98188 <br /> OWNER PHONE: 206-838-3847 OWNER EMAIL: l -�— <br /> CONTRACTOR NAME: TBD /'t '9,- 3�; ii (�;rj'5 �e"v� 170 , <br /> CONTRACTOR ADDRESS: STREET / �j l cZ Fr) i i C <br /> CITY d ` L- STATE LZ/ zip 7 <br /> CONTRACTOR PHONE: Z�;- 2J " 71j5 - 5�%L'L CONTRACTOR EMAIL: ^I (���- _.i��; �^v"� rn c. �,t I" <br /> CONTRACTOR LICENSE#(REQUIRED):11/0,' t hL L CiA C U CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): C"SSI (t <br /> PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR ZI OTHER(Please Specify) Architect <br /> CONTACT NAME: CONTACT PHONE: 425-646-1818 <br /> SynThesis - John Llacuna CONTACT EMAIL: John.Llacuna@Synthesispllc.com <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: Business/Storage/Manufacturing Contract Price of Work: $ 175,000 <br /> Proposed Use of Building: Business/Storage/Manufacturing Heat Source: V]Gas ❑Electric []Other <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ZICommercial ❑Industrial <br /> Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ZT.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: <br /> Construction of new Offices, Toilet Rooms and Break Room. Scope to include wall framing, suspended ceiling, fixtures and finishes. <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <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/ 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 1 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 ra 0,Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> PER <br /> Owper/Authorized Agent Signature Date (Revised 9/23/2016) <br />