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PERf1�IT l�PPLICA7IC:.".' <br /> BUILDI� MECHANICAL / PLUMBIfVG / SIGI tb. ,PRINKLER / 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 Ink Only Please) PROJECT SITE INFOFtMAT10N <br /> 28050700203700,00394000008600, <br /> PROJECT SITE ADDRESS: 7207 Ever reen Wa Suite X8�Y PROPERTY TAX#:00394000008700 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Alex Kim TENANT NAME(If Commercial): Enchanted Little Forest Child Care <br /> OWNER MAILING ADDRESS: srREET 5015 Dover St. <br /> cirv Everett sTArE WA ZiP 98203 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: Owner <br /> CONTRACTOR ADDRESS: srREET <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): <br /> PRIMARY CONTACT: ❑ OWNER ❑ CONTRACTOR �OTHER(Please Specify) Architect <br /> CONTACT NAME: CONTACT PHONE: (425)252-2153 <br /> 2812 architecture-Adam Clark CONTACT EMAIL: adam@2812architecture.com <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: Day Care Contract Price of Work: $ 7,500.00 <br /> Proposed Use of Building: Day Care Heat Source: ❑Gas ❑Electric ❑Other <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: �Commercial ❑Industrial <br /> Type of Project: ❑New ❑Addition ❑Remodel ❑Repair �T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: <br /> New gate in existing fenced area,and demonstration of exiting compliance of tenant space. <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New _ Addn _Alteration _Repair Type of Project: _New _Addn _Alteration _Repair <br /> #of Lisf of Fixtures #of Lisf of Fixtures #of List of Fixtures #of List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <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 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 (Service/Bar/Mop/etc.) Other: <br /> SPRINKLER/ SUPPRESSION SYSTEM <br /> Number 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 /> cur�ent 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 1 am authorized by the owner of this property to perform fhe work for which application is made, <br /> and 1 comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> "'� City of Everett Official Use Only <br /> ��+-' P I T# <br /> � ��� a -- ��� '�� <br /> ner/Authorized Agent Signature Date (Revise 5/20/2016) <br />