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I IIII PERMIT APPLICATIO�III
<br /> BUILDIN�IECHANICAL/ PLUMBING /SIGN �3P'RINKLER/ DEMOLITION
<br /> CITY OF EVERETT PERMITSERVICES
<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: 3003 W�Casino Rd. � � PROPERTY�TAX#: Zg0411�00200100 � � � � � �� � � � �
<br /> LEGAL for new construction: Short PlaUsubdivision !� Lot No. (attach copy of long legal description)
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<br /> OWNER NAME: Boeing Co TENANT NAME(If Commercial):
<br /> OWNER MAILING ADDRESS: s-rReer PO Box 3707 M/S OH-13
<br /> crrv Seattle sTAre WA ziP 98124-2207
<br /> OWNER PHONE: 425-239-7983 OWNER EMAIL: david.d.tyler@boeing.com
<br /> CONTRACTOR NAME;
<br /> CONTRACTOR ADDRESS: sTReET '
<br /> CITY � � STATE � ZIP
<br /> CONTRACTOR PHONE: CONTRACTOR EMAIL:
<br /> CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): $4�
<br /> PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR ❑OTHER(Please Specify)
<br /> CONTACT NAME: CONTACT PHONE: 425-239-7983
<br /> Dave Tyler coNT,acT eMaic: david.d.tyler@boeing.com
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<br /> Existing Use of Building: Manufacturing Contract Price of Work:$
<br /> Proposed Use of Building: Pallet Rack Heat Source: ❑Gas ❑Electric ❑Other
<br /> Buildin Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Famil -#of Units: ❑Commercial C�Industrial �
<br /> Type of Project: �New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use
<br /> DESCRIPTION OF WORK:
<br /> Building No. 40-23.4-Col I-5.5. Install 12' Pallet Rack-Crane Maintenance Crib
<br /> ASSOCIATED BUILDING PERMIT# if a licable :
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<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 Handiing Units Heat Pump Toilet Backflow Preventer(Inside Bldg)
<br /> Forced AirSystems 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(Seroice/Bar/Mop/etc.) Other.
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<br /> ACKNOWLEDGEMENT.•I have�eviewed 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.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 Confractors Law 18.27 RCW and 296.200A WAC.
<br /> City of Everett Official Use Only
<br /> 1 PERMI
<br /> / . c �6 I (� — d�
<br /> Owner/Authorized Agen gnature te (Revised 10/12/2015) �
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