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PERMIT APPLICATION <br /> BUILDING/MECHANICAL/ PLUMBING /SIGN /SPRINKLER/ DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 � FAX 425-257-8857 �(E)everetteps@everettwa.gov� www.everettwa.gov/permits <br /> (Blue:"or. Black 1nk Onl�'�leas�. ' _.;: PROJ�CT.$I.TE:7N�t?RMItTION?,' - : ; , ,,-. , ; <br /> � ;��- � <br /> PROJECT SITE ADDRESS: 3003 W. Casino Rd. -Bldg 40-01 PROPERTY Tax#: 28041000100200 <br /> LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br /> ..�: <br /> . ' . . " .:. .. C�NTAC'T.INFORNfA�ION: <br /> OWNER NAME: Th2 BOelfl CO. TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: s-rReer PO Box 3707 MS OH-13 <br /> cir. Seattle sTATE WA ZiP 98124-2207 <br /> OWNER PHONE: 206-650-0100 OWNER EMAIL: james.p.nuerenberg@boeing.com <br /> CONTRACTOR NAME; General Construction Company <br /> CONTRACTOR ADDRESS: srrteEr <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: NA CONTRACTOR EMAIL: NA <br /> CONTRACTOR LICENSE#(REQUIRED): GENERCC9830Z CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 040599 <br /> ��. _ .,__ ,�. _�. __ � <br /> PRIMARY CONTACT: �OWNER ❑CONTRACTOR ❑OTHER(Please Specify) � <br /> CONTACT NAME: CONTACT PHONE: 206-650-0100 <br /> Jlm NUerenberg CONTACT EMAIL: <br /> james.p.nuerenberg@boeing.com <br /> ��. BUILD[NCs,',PERMIT APPL[CATION ' <br /> Existin Use of Buildin : Contract Price of Work:$ 225,000 <br /> Pro osed Use of Buildin : Heat Source: ❑Gas ❑Electric ❑Other <br /> Buildin T pe: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial �Industrial <br /> Type of Project: ❑New ❑Addition ❑Remodel ❑Repair l$IT.I. ❑Si n ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: <br /> Replace toilet room accessories and create two new unisex ADA-compliant restrooms within existing restrooms. Convert <br /> storage room to breakroom. <br /> ASSOCIATED BUILDING PERMIT# if applicable : <br /> MECHEINICAL:.pERMIT"R�PLICATIQN :''., .. :''.=I��.UMBING PERMIT':ARP�I.C�tTfO� .=.. . <br /> Type of Project: _New Addn _Alteration Repair Type of Project: _New _Addn _Alteration _Repair <br /> #of List of Fi�ures #of List of Fixtures #of List of Fi�ures #of List of Fixtures <br /> Fixtures Fi�ures Fixtures FiaRures <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 Lavato (Wash Basin) Drinking Fountain <br /> Water Heater Refrigeration Shower Floor Drain <br /> Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap <br /> Gas Ran e 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 f'SI�RRRESSIE�N�SYSTEIV��x� ��:. <br /> Chemical or Water No.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 I am 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 /> `G ���1� PERMIT�I�6 vJ V1,� <br /> OwnprlAut r' e Agent Sig a r Date (Revised 9/23/2016) <br /> �� <br />