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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 Blaak Ink��Only Plea�s�)�. s �� ��� �:-•..PROJECT SIT���1NFORMATION����� , ��..>.;=.,� �� � �� <br /> PROJECT SITE ADDRESS: 15 SW Everett Mall Way, Suite E and F PROPERTY TAX#: oo4s0201101400,28042400100300 <br /> LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> owNeR Nanne: Rosen Properties TENANT NAME(If Commercial): VaC811t under this ermit <br /> OWNER MAILING ADDRESS: srReer 1800 112th Ave NE, Suite 312-E <br /> �iTM B2118VU2 STATE WA ziP 98004 <br /> OWNER PHONE: OWNER EMAIL: VlCkym�a YOSenprOpenleS.COm <br /> CONTRACTORNAME: TB� A�LS �l,�,t "t(� � �.- <br /> CONTRACTORADDRESS: sTReeT O � G e�vn/a� ��1�- �� I�Oaf. <br /> CITY ,� ` �'�' STATE ZIP � � <br /> CONTRACTOR PHONE: � � ���.- �{� CONTRACTOR EMAIL: � <br /> CONTRACTOR LICENSE#(REQUIRED): 4.�. 7'��-�s S.� j Q� d CITY OF EVERETT BUSINESS LICENSE#(REQUIRE ); ��IQ <br /> PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR �OTHER(Please Specify) FI'@Ih@It afld HO,AfChIt2CtS, If1C., P. . <br /> CONTACT NAME: Michae) Langston CONTACT PHONE: (425) 827-2100 - <br /> CONTACT EMAI�: mlangston@fhoarch.com <br /> �. � �_, �,., � <br /> � � BUIG�DING:PERMIT APPLICATION� � � � �"�� �� <br /> Existing Use of Building: B-VaCarlt Contract Price of W :$ 34 000.00 <br /> p g: B/M -Vacant xis ing no c ange <br /> Pro osed Use of Buildin Heat Source: ❑G ric ❑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 /> �escRiPrioN oF woRK: Interior remodel of existing vacant suite (E and F) converted to vanilla shell/market ready. Work to <br /> include construction of new non-structural demising and partition walls, (1)ADA compliant single occupant restroom in each <br /> suite-plumbing drawings under separate permit. <br /> ASSOCIATED BUILDING PERMIT#(if applicable : <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: New _ Addn _Alteration Re �r Type of Project: New _Addn _Alteration Repair <br /> #of List of Fixtures #of Li of Fixtures #of ��st of Fixtures #of Lisf of Fixtures <br /> Fixtures Fixfures Fixtures Fixtures <br /> A/C—Air Handling Units eat Pump Toilet B flow Preventer(Inside Bldg) <br /> Forced Air Systems Unit Heater Bathtub rinal <br /> Gas Piping Boiler Lavatory(Wash Basin) Dr' king Fountain <br /> Water Heater Refrig tion Shower FI o Dra' <br /> Gas Fireplace Wood ove Kitchen Sink&Disposal Gr rap <br /> Gas Range D g Dishwasher R Drains <br /> Clothes Dryer Hoo ps er: Clothes Washer edical Gas <br /> Range Hood Water Heater Other: <br /> Exhaust Fa Sink(Serv' /Bar/Mop Other: <br /> SPRINKLER/SUPPRESSION SYSTEM <br /> Chemical or Water No.of Heads <br /> ACKNOWLEDGEMENT.•I have reviewed this application and confirm the information contained he�ein 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 deviaEions therefrom.Deviations must first be authorized in writing from the <br /> Building O�cial before being authorized under any circumstance.I am the owner,or l 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 La 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> e IT# ��/� <br /> � 05.31.2017 '—C�IJ� <br /> Owner Authorized Agen i ature Date (Revised 9/23/2016) "" ' ° <br /> �� �� <br />