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PERMIT APPLICATI <br /> ,IIIP BUILDII� I MECHANICAL/ PLUMBING /SIG PRINKLER/ DEMOLITION <br /> 1� CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> (Blueeor,Black Ink Only'Please)'. PROJECT SITE INFORMATION M1= ,',} ,. F ; <br /> PROJECT SITE ADDRESS: 10200 25TH AVE SE, EVERETT, WA 98208 PROPERTY TAX#: 28052000200900 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> ONT'ACT INFORMATION - <br /> OWNER NAME:EVERETT SCHOOL DISTRICT TENANT NAME(If Commercial): EISENHOWER MIDDLE SCHOOL <br /> OWNER MAILING ADDRESS: STREET 3900 BROADWAY <br /> CITY EVERETT STATE WA Zip 98201 <br /> OWNER PHONE: (42 '85-41.5 OWNER EMAIL: JCOLLINS@EVERETTSD.ORG <br /> CONTRACTOR NAM 1 0 <5 w-vps <br /> ), <br /> CONTRACTOR ADD ESS: STREET <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUa' <br /> IRED) O , 9i� <br /> ITE <br /> PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR ®OTHER(Please Specify)ARCHITECT <br /> CONTACT NAME:STEVE LEE/ CONTACT PHONE:(206) 587-3797 <br /> STUDIO MENG STRAZZARA CONTACT EMAIL: SLEE@STUDI.►-- f S.Co <br /> \ <br /> . .y ? " q r z., :._.,,BUIL DING'PERM1T;APPLICATIQN , .. F . x,. ,z . . <br /> x .. __. .. <br /> Existing Use of Building:MIDDLE SCHOOL Contract Price of Wore$ „15,000 <br /> Proposed Use of Building:MIDDLE SCHOOL Heat Source: ❑Gas (i)Electric ❑Other <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: %4 Commercial ❑Industrial <br /> Type of Project: I, New ❑Addition ❑Remodel ❑Repair DTI. ❑Sign ❑Sprinkler ki •-molition ❑Change of Use <br /> DESCRIPTION OF WORK: <br /> ADDING (1) PORTABLE CLASSROOM, P6, WITH WELCOME RAMPS & STAIR. <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> j qVtlit'OIANICALPERMIT APPLICATION PLUMBING PERMIT,APPLI ATION' }s P <br /> Type of Project: _New _ Addn _Alteration _Repair Type of Project: _New _Addn _Alteration -epair <br /> #of List of Fixtures #of List of- "tures #of List of Fixtures #of 1st of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> A/C—Air Handling Units H-..`'ump Toilet :-ckflow Preventer(Inside Bldg) <br /> Forced Air Systems nit Heater Bathtubal <br /> Gas Piping Boiler Lavatory(Wash Basin) D ing Fountain <br /> Water Heater Refrig: ion Shower FI••ep Drain <br /> Gas Fireplace Wood:it <br /> Kitchen Sink&Dispos- '!se Trap <br /> Gas Range Ductin,, Dishwasher Roof Drains <br /> Clothes Dryer Hoe ups 0 .: . Clothes Washe !., Medical Gas <br /> Range Hood !r. Water Heat: 4 Other: <br /> Exhaust F- Sink(S-,-lice/Bar/Mop/et . Other: <br /> SPR /,,, <br /> z , LER SUPPR 'S <br /> ESSIONYSTEM Az- <br /> Chemical or Water I No.of Heads <br /> ACKNOWLEDGEMENT:1 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 lam 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 /> PERM <br /> ' // / 'Slq0Cie -0(09 <br /> Owner/Authori ed Agent Signature Date/ / (Revised 9/23/2016) tI <br />