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I <br /> CA&C PERMIT APPLICATIIIII <br /> ,,// o" ''�� BUILDIIMECHANICAL/PLUMBING /SIPRINKLER/DEMOLITION <br /> h . - <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 /> (Blue;`or.Black:Ink Only Please) . PROJECT.SITE INFORMATION <br /> PROJECT SITE ADDRESS:120 SE Everett Mall Way, Everett, WA 98208 PROPERTY TAX#I (pp 4P10 Il am <br /> LEGAL for new construction: Short Plat/subdivision ' Lot No. (attach copy oflong legal description) <br /> i <br /> CONTACT-INFORMATION. , _ <br /> OWNER NAME: Karl Johnstone — p//►AaGle 14/i1 TENANT NAME(If Commercial): / 1A/1(COS$ AM. <br /> OWNER MAILING ADDRESS: STREET 2801 Alaskan Way, Suite 200 J <br /> cm(Seattle STATE WA ZIP 98121 <br /> OWNER PHONE: 0: (206)215-9850 I F: (206)215-9950 I C: (425)591-0296 OWNER EMAIL: kjohnstone@a pinnacieliving.com <br /> CONTRACTOR NAME, 'g 1 S.2 e• -Cp <br /> Ua.A ��l 7 t:A l 61 <br /> CONTRACTOR ADDRESS: STREET 1k-{23 S '2_6 A--4-Q.\___ %-kk.CITY Q..-- STATE zIpctg lck (�/ <br /> Y <br /> CONTRACTOR PHONE:2S3O 5 .r152[3 CONTRACTOR EMAIL: �l <br /> CONTRACTOR LICENSE#(REQUIRE.r:6 k bV Lk 9.-4 t ITY OF EVERETT BUSINESS LICENSE#(REQUIRE�' ! • ti . �.� <br /> 4 <br /> PRIMARY CONTACT: ❑OWNER la _e NTR/ACTOR OTHER(Ple pecify) MI4eo r' <br /> CONTACT//NT� NAME: <br /> pigh- / —�j((.lGl Sf'►p7, CONTACT PHONE: (4w) y. 7�8(' <br /> l[/[/9-le Ave. N . (iWyve (0' 98064- CONTACT EMAIL: ban,55m/-Jl ow�US,Cm i <br /> . ,BUILDING PERMIT„APPLICATION �,.. <br /> Existing Use of Building: Apartment Cor'teK Contract Price of Work:$ �� /7)`5ZD <br /> Proposed Use of Building:Storage-g.f.ezor� � CM <br /> , p(29G ❑ <br /> Heat Source: Gas DElectric ❑Other N/A — hetffift <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑In ustrial %,111:'fl <br /> Type of Project: New ❑Addition ❑Remodel DRe pair CIT.!. OSign ❑Sprinkler ❑Demolition ❑Change of Use ►►iii <br /> DESCRIPTION OF WORK: 50a7Wya`e V <br /> Storage of goods in non-heated space. Building used for on-site maintenance team for building materials,non-hazardous,and other storage meeting S-2 classification <br /> ASSOCIATED BUILDING PERMIT#(if applicable): M ipc <br /> MECHANICAL'PERMIT.:APPLICATION : r fPLOMB IRO 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 Fixt <br /> ures es List of Fixtures Fixtures <br /> List of Fixtures <br /> O�A/C—Air Handling Units Heat Pump �oilet Backflow Preventer(Inside Bldg) <br /> .� Forced Air Systems Unit Heater L/ 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 /> ,,, PRINKLEIRI,c,SUPPRESS,ION SYSTEiCz7d;, <br /> Number of Heads <br /> ACKNOWLEDGEMENT:1 have reviewed this application and confirm the information contained herein is true and convect.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.lam the owner,or lam authorized by the owner of this property to perform the work for which application is made, <br /> and I corn. withthe State Contractors Law 18.27 RCW and 296.200A WAC. <br /> 01 7....L, City of Everett Official Use Only <br /> /�; ( PERMIT# <br /> 111A '1 ( ti ) IInr�- l(v 111, 10— oca <br /> Own- /Authorized gent ignature Date (Revised 9/23/2016) 1 <br />