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r <br /> PERMIT APPLICATIOAI <br /> i0IMIP' Ci:" -"" BUILDIN•I I MECHANICAL/PLUMBING/SIGPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 l'(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> (Blue orBlack Ink Only Piease) „ PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: 120 SE Everett Mall Way, Everett, WA 98208 PROPERTY TAX#( Ci4/6/0 Aatq l-70,. <br /> LEGAL for new construction: Short Plat/subdivision ) Lot No. (attach copy oflong legal description) <br /> . y. CONTACT INFORMATION - :. <br /> OWNER NAME: Karl Johnstone — p/,,,,G4,IC GI/ri� TENANT NAME(If Commercial): fb/ vac (/'ssth j kis. <br /> OWNER MAILING ADDRESS: STREET 2801 Alaskan Way, Suite 200 it __ <br /> cm,Seattle. STATE WA ZIP 98121 <br /> OWNER PHONE: O: (206)215-9850 I F: (206)215-9950 I C: (425)591-0296 OWNER EMAIL: kjohnstone@pinnacleliving.com <br /> ` rr ` <br /> CONTRACTOR NAME:' t�� C Y uc�l�� `-- _f ,C_, BOO <br /> CONTRACTOR ADDRESS: STREET\VA .).-__C S 2125 "\ - <br /> CITY ( _ ;C,A-e STATE``!'41'r"--41'r"-- ZIP OC g <br /> CONTRACTOR PHONE: 2... S — Cj p g'- 20 CONTRACTOR EMAIL: <br /> CONTRACTOR LICENSE#(REQUIRED): 16 E(L5 ( \ ' -si) `L_ CITY OF EVERETT BUSINESS LICENSE#(REQUIRE 1 : I ../ <br /> PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR'/ OTHER(Please Specify) r <br /> - 1/ "I In c CONTACT PHONE: (4 14) f�1. 7686' 1 <br /> '-CONTACT N�AMIE: t.� /gyp, <br /> �L�/����(! N . P�IE(I(1� Wim' "IVc6 CONTACT EMAIL: bia SIymth em ai -USiCOYy, <br /> t ,BUILDING PERMIT APPLICATION _ : _ <br /> Existing Use of Building: Apartment ComQIe)C Contract Price of Work:$ aflit, Z /7/570 C <br /> Proposed Use of Building:Storage-Actes5o1 *copy,' ,`�,�(, Heat Source: ❑Gas ❑Electric DOther N/A -',I 114 IA <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ODuplex' ❑Multi-Family-#of Units: ❑Commercial Din ustrial %i h# <br /> y <br /> Type of Project: XNew DAddition El Remodel ❑Repair DTI. ❑Sign ❑Sprinkler ODemolition ❑Change of Use />Ir <br /> DESCRIPTION OF WORK: No i" ale... <br /> /qq tidy <br /> Storage of goods in non-heated space. Building i bed for on-site maintenance team for building materials,non-hazardous,and other storage meeting S-2 classification <br /> ASSOCIATED BUILDING PERMIT#(if applicable): M <br /> MECHANICAL'PERMIT APPLICATION PLUMBING PERMITAPPLICATION <br /> Type of Project: _New _ Addn _Alteration _Repair Type of Project: _New Addn Alteration _Repair <br /> #of List of Fixtures #°f List of Fixtures #°f List of Fixtures #°f List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> O' A/C—Air Handling Units Heat Pump /�'��ollet Backflow Preventer(Inside Bldg) <br /> /' Forced Air Systems Unit Heater V 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 /> PRINKLER i SUPPRESSION SYSTEM.:; ; <br /> 'r 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 th- <br /> Building Official before being authorized under any circumstance.I am the owner,or I am authorized by the owner of this property to perform the wo for I. --_'- ade, <br /> and I com. with the State Contractors Law 18.27 RCW and 296.200A WAC. 5 �, l/�_ <br /> City of Everett 4/1....ua'e Tfii <br /> /1/ r ( PERMIT# <br /> cCIr1V) 110* 1w a/to.i0 -011 a <br /> Own- /Authorized ,gent ignature Date (Revised 9/23/2016) ‘IW' <br />