5200 EVERGREEN WAY 2018-05-16 - Laserfiche WebLink

PERMIT APPLICATIO� BUILDINt� 1 MECHANICAL/ PLUMBING /SIGN / SPRINKLER/ DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 � FAX 425-257-8857 �(E)everetteps@everettwa.gov� www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: �JZOO EV@I'gl'@eCl Way PROPERTY TAX#: LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: EpIC FOfd TENANT NAME(If Commercial): OWNER MAILING ADDRESS: sTrxeEr 5200 Evergreen Way �,n Everett STATE WA ziP 98203 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: B@PC)/SIgCI SyStefllS CONTRACTOR ADDRESS: sTREET 7400 Hardeson Rd cirv Everett STATE WA ziP 98203 CONTRACTOR PHONE: 425.776.8835x114 CONTRACTOR EMAIL: tracies ber si ns stems.com - CONTRACTOR LICENSE#(REQUIRED): berrySSH57fJ7 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED):i424786 ! PRIMARY CONTACT: ❑OWNER �CONTRACTOR ❑OTHER(Please Specify) �---' CONTACT NAME: CONTACT PHONE: 425.776.8835 X��4 Tracie Skiles CONTACT EMAIL:tracies@berrysystems:Gpm BUILDING PERMIT APPLICATION / Existin Use of Building: Contract Price of Work: S �O.'I 65.00/ Proposed Use of Building: Heat Source: ❑Gas Electric ❑Other Buildin T pe: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Famil -#of Units: ❑Commercial ❑Industrial T pe of Pro�ect: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. �Si n ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: remove cabinet on pole and add a smaller one ASSOCIATED BUILDING PERMIT# if a licable : MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Type of Project: _New _ Addn Alteration _Repair Type of Project: New Addn Alteration _Repair #of List of Fixtures #°f List of Fiutures #°f List of Fixtures #°f List of Fixtures Fixtures Fi�rfures Fixtures Fixtures A/C—Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) Forced Air S stems Unit Heater Bathtub Urinal Gas Piping Boiler Lavatory(Wash Basin) Drinking Fountain Water Heater Refri eration Shower Floor Drain Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap Gas Range Ducting Dishwasher Roof Drains Clothes Dryer Hookups Other: Clothes Washer Medical Gas Range Hood Water Heater Other: Exhaust Fan Sink Service/Bar/Mop/etc. Other: SPRINKLER/SUPPRESSION SYSTEM Number of Heads ACKNOWLEDGEMENT:I have reviewed this application and confirm the information contained herein is true and correct.Work done pursuant to this pennif must comply with 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 Building O�cial 6efore being authorized under any circumstance.1 am the owner,or I am authorized by the owner o(this property to perform the work for which application is made, and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. - City of Everett O�cial Use Only PE IT# � �, � �_ � ��aZ -- ��- Owner/A hori ent gnatu Date (Revised 9/23/2016) �j�