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PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar Sl., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.evereth:ra.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM /.? —/ F— / Z <br />SITE ADDRESS: <br />3202 20th Street, Everett, WA 98201-2615 <br />PROPERTY TAX# <br />00563241100100 <br />2 , r <br />[,�Xi <br />C <br />LEGAL for new construction: Short Plat/subdivision— Lot No._ (attach copy of long legal description) ,I <br />OWNER Washington State Department of Transportation <br />PhonelE-mail 206-768-5703 / bakerw@wsdol.wa.gov <br />I <br />Address 6431 Corson Ave S <br />9 <br />y Seattle / WA / 98101 <br />cn lstalerzip <br />APPLICANT: _% -Owner Owner's Agent _Contractor _ Contractor's Agent Tenant(must provide a lever of coes"Iftom me enaerta dowoi* in the space) <br />CONTRACTOR WSDOT - Wayne Baker <br />L 8 I Lic. # COE mus. Lic. # <br />Address 6431 Corson Ave S / Seattle / WA 198101 PhonelEmad 206-768-5703/bakerw@wsdot.wa.gov <br />TENANT BUSINESS NAME <br />WSDOT-Everett Signals / Bridge Maintenance Facility <br />CONTACT FOR PERMIT Wayne Baker <br />Ilphone/E-ma,l 206-768-5703 / bakerw@wsdot.wa.gov <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK 5ODfl OL' <br />Existing Use of Building General Office HEAT SOURCE: <br />Proposed Use of Building General Office (no change) Gas X Electric_ Other_ <br />Building type: _ Single Family _Duplex _Townhouse _ Multi -Family X Commercial <br />Type of project: __New Addition Remodel Repair X T.I. Sin Sprinkler _ Demolition _Chane of Use <br />DESCRIPTION OF WORK (additional space provided on the back): <br />Convert an existing storage room into a locker room (with lavatory for hand washing) and a shower room. <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New_Addn X Alteration _Repair <br />Show Number (0) of fixtures <br />Type of Project: _New _ Addn %t Allaration _Repair <br />Show Number (#) of fixtures <br />I A/C —air handling units <br />X Forced airs stems <br />I Toilet <br />I Bathtub <br />X Gas pipingX <br />Lavatory(wash basin) <br />X Water healer <br />X I Shower <br />I Gas fireplace <br />Kitchen sink & disposal <br />Gas ran e <br />I Dishwasher <br />Clothes dryer <br />Clothes washer <br />Range hood <br />-titrate!F'-'-- <br />X Exhaust fan <br />Sink (serricelbar/mo lett.) <br />Heat pump <br />I Backflow preventer <br />Unit heater <br />Urinal <br />Boiler <br />Drinkin Fountain <br />Refriaeration <br />Floor drain <br />Woodslove <br />I Grease trap <br />X I Ducting <br />I Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />Roof drains <br />Medical Gas <br />other: <br />Other: <br />I hereby certify that I have read and examined this appkcalon and know the same to be me and correct. All provsons of laws and ordinances governing this type of work wit be compied <br />with whether specired herein or not. The granting of a permit does mt presume to give aulhon ly to volate or cancel the provivon of any other state or local law regulating coratimcton <br />That I am authorized by the owner, o1 this property to perform the work for which application s made and I comply arm the State Contractors Law 18.27 RCW and 296 200A WAC&ail . / <br />10-16-12 Y 2 <br />Owner/Author/ d Agent Signature Date (Revised f✓2072) <br />