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PERMIT APPLICATI � <br /> BUILDI� MECHANICAL/ PLUMBING / SI�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 /> (Btue`o'r' Biack Ink'On1y Pfease): � PROJ�CT S('�E INFORMATtON ' F,. <br /> .,. „ _ ,�, < � __ . �_-_-_. <br /> 28050700203700,00394000008600, <br /> PROJECT SITE ADDRESS: 7207 Ever reen Wa Suite F PROPERTY TAX#:00394000008700 <br /> LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br /> - CONTACT 1N,FORMATION <br /> OWNER NAME: Alex Kim TENANT NAME(If Commercial): Victory Church <br /> OWNER MAILING ADDRESS: sTReer 5015 Dover St. <br /> ci-n Everett STATE WA ziP 98203 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME; Owner <br /> CONTRACTOR ADDRESS: sTReeT <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS UCENSE#�REQUIRED): <br /> PRIMARY CONTACT: ❑ OWNER ❑CONTRACTOR L34 OTHER(Please Specify) Architect <br /> CONTACT NAME: CONTACT PHONE: (425)252-2153 <br /> 2812 architecture-Adam Clark CONTACT EMAIL: adam@2812arc ' om <br /> - SUILDING PE�2M1'f APPL�CATIO„ <br /> Existing Use of Buiiding: Church Contract Price of W k:$ 3,000.00 <br /> Proposed Use of Building: Church Heat Source: ❑G s ❑Electric Other <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Unit Commercial ❑Industrial <br /> Type of Project: ❑New ❑Addition ❑Remodel ❑Repair �T.I. ❑Sign ❑Sprinkler Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: <br /> Update of exiting to current code compliance <br /> ASSOCIATED BUILDING•'P�RMIT#(if applicable): <br /> ', .� .; MEGH.ANICAL �P�ERMIT APPLICATION ';. PWMB�sNG PERMIT APPLICATION �, ' <br /> .�.� �� <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 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/Mbp/etc.) Other: <br /> SPRIN�CLER/SUPPRESSION SYSTEM ' <br /> Number 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 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 /> PE � � ��� _ oc � <br /> Owner/Authorized Agent Signature Date (Revised 5/20/2016) <br /> i �R . <br />