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PERMIT APPLICATION ��I�
<br /> BUILDING / MECHANICAL/ PLUMBING /SIGN /S KLER/ 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
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<br /> PROJECT SITE ADDRESS: PROPERTY TAX#: 2g4041000100200
<br /> 3003 W Casino Rd,Everett,WA 98204
<br /> LEGAL fOr I�EW COI�St�UCtIOI�. ShOIrt PIaUSUbC�IVISIOi� SECtOTNP28RGED4E1(lOFSECEXCCASINORO Lot No. (attach copy of long legal description)
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<br /> OWNER NAME: Boeing TENANT NAME(If Commercial): Boeing Company
<br /> OWNER MAILING ADDRESS: sTReer Building 40-0 �,p�/` a,. (�.Z ��j,� YY�OUY1 � �
<br /> crrv R STATE WA ziP 98204
<br /> OWNER PHONE: OWNER EMAIL:
<br /> CONTRACTOR NAME, MacDonald Miller
<br /> CONTRACTOR ADDRESS: sTREEr 7717 Detroit Ave SW
<br /> cirv Seattie sTATE WA zia 98106
<br /> CONTRACTOR PHONE: (206) 768-4278 CONTRACTOR EMAIL: permits@macmiller.com
<br /> CONTRACTOR LICENSE#(REQUIRED): MACDOFS9HORU CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): O4O6F)S
<br /> PRIMARY CONTACT: ❑OWNER �CONTRACTOR ❑OTHER(Please Specify)
<br /> CONTACT NAME: �oyce Copley CONTACT PHONE: (206) 768-4278
<br /> CONTaCT ennai�: Joyce.Copley@macmilier.com
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<br /> Existin Use of Buildin : CALL CENTER Contract Price of Work:$ �P�J��J'~ ��
<br /> Proposed Use of Buildin : NO CHANGE Heat Source: ❑Gas �Electric ❑Other
<br /> Buildin T pe: ❑SFR-Detached ❑SFR-Attached ❑Du lex ❑Multi-Famil -#of Units: OCommercial ❑Industrial
<br /> T e of Pro'ect: ❑New ❑Addition ❑Remodel ❑Re air �T.I. ❑Si n ❑S rinkler ❑Demolition ❑Chan e of Use
<br /> DESCRIPTION OF WOR
<br /> Bldg 40-04—we are replacing qty�existing drinking fountains with new ones in same locations and removing qty�ycompletely
<br /> ASSOCIATED BUILDING PERMIT# if a licable :
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<br /> Type of Project: _New Addn X 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 Fi�ures Fixtures Fixtures
<br /> A/C—Air Handlin Units Heat Pump Toilet Backflow Preventer Inside Bld )
<br /> Forced Air S stems Unit Heater Bathtub _ Urinal
<br /> Gas Pipin Boiler Lavato (Wash Basin) Drinkin Fountain
<br /> Water Heater Refri eration Shower Floor Drain
<br /> Gas Fireplace Wood Stove Kitchen Sink&Dis osal Grease Tra
<br /> Gas Ran e Ductin Dishwasher Roof Drains
<br /> Clothes D er Hooku s Other:VAV Boxes Clothes Washer Medical Gas
<br /> Ran e Hood Water Heater Other:
<br /> Exhaust Fan Sink Service/Bar/Mo /etc. Other:
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<br /> ACKNOWLEDGEMENT.�1 have reviewed this application and confirm the information contained herein is true and correck 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.l am the owner,or 1 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 /> PERMIT#
<br /> _C�/���—� �� 1/12/2016 � D '�` �
<br /> Owner/Authorized Agent Signature Date (Revised 10/12/2015)
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