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PERMIT APPLICATION <br /> BUILDING/ MECHANICAL/ PLUMBING /SIGN /SPRINKLER/ DEMOLITION <br /> 477 <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> ,, .;,:;*ROJECTSITE`'INFORMATION :5,,,,,,,, <br /> PROJECT SITE ADDRESS: 3003 W Casino Rd. PROPERTY TAX#: 280415000100100 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> .CONTACT INFORMATION - <br /> OWNER NAME: Boeing Co TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET PO Box 3707 M/S OH-13 <br /> crry Seattle STATE WA zIP 98124-2207 <br /> OWNER PHONE: 425-260-2668 OWNER EMAIL: todd.j.haberlack@@boeing.com <br /> CONTRACTOR NAME: TBD-The contract is out for bid <br /> CONTRACTOR ADDRESS: STREET <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> CONTRACTOR LICENSE#(REQUIRED): TBD CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): TBD <br /> PRIMARY CONTACT: ®OWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 425-260-2668 <br /> Todd Haberlack CONTACT EMAIL: todd.j.haberlack@boeing.com <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: N/A Contract Price of Work:$ 112,000 1 3 7 ei9D <br /> Proposed Use of Building: 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 /> Access, demo and replace walls Minor reconfiguration of bathroom partion walls. <br /> ASSOCIATED BUILDING PERMIT#(if applicable): t�v VO ' C141 ' rT— �` <br /> MECHANICAL PERMiT APPLICATION �;: IPirUIVIBING PERMIT APPLICATION <br /> Type of Project: _New _ Addn Alteration _Repair Type of Project: New _Addn _Alteration _Repair <br /> #of List of Fixtures #of <br /> Fixtures Fixtures List of fixtures Fixtures List of Fixtures Fixtures List xtures <br /> NC—Air Handling Units H Pump Toilet Backfl reventer(Inside Bldg) <br /> Forced Air Systems nit Heater Bathtub U ' al <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 Ho ps Other: Clothes Washer Medical Gas <br /> Range Hood Water Heater Other: <br /> Exhaust Fa Sink(Servi Bar/Mop/etc.) Other: <br /> SPRINKLER f.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.-fore being authori d 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 compl ith t e State Contractor Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> 444 7-11- if Pc�O`� — 039 <br /> Ow er •uthorized Age t Signature Date (Revised 10/12/2015) <br /> 6-ij <br />