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PERMIT APPLICATION <br /> 001111%.',/%,".. BUILDING /MECHANICAL/PLUMBING /SIGN /SPRINKLER/ DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 i FAX 425-257-8857 I(E)everetteps@everettwa.gov I www,everettwa.govipermits <br /> 0144i-'4P-i, .. b ink ";,' I : , i ►Tt i '",., ,: z:''',,-!.:,:,',7','& : v <br /> PROJECT SITE ADDRESS:71 00 Hardeson Road, Everett, WA 98203 PROPERTY TAX#: <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> • <br /> OWNER NAME: Community Transit TENANT NAME.•(If Commercial): <br /> a <br /> OWNER MAILING ADDRESS: STREET 7100 Hardeson Road <br /> ciTY Everett STATE WA zip 98203 <br /> OWNER PHONE: (425) 348-7100 OWNER EMAIL: larry.daubenmire@commtrans.org <br /> CONTRACTOR NAME:'1dUL/ <br /> CONTRACTOR ADDRESS: STREET <br /> CITY TIM _. STATE <br /> -- ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> CONTRACTOR LICENSE#(REQUIRED) CITY OF EVERETT BUSINESS LICENSE#(REQUIRED) DSti ail <br /> . _ <br /> PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR 8 OTHER(Please Specify) > Ot> = 'j" <br /> CONTACT NAME: CONTACT PHONE: (425) 348-7100 <br /> Larry DaubenmlreCONTACT EMAIL: Iarry.daubei e@ •mmtranS.Org <br /> ice,.. �„ : L'� <br /> Existing Use of Building: Maintenance Operations Contract Price_of Work. ', ' — '0 , Q00 e <br /> Proposed Use of Building:Mainentance Operations Heat Source IDGas ...❑Elect.rric 0 other <br /> Building Type: ❑SFR-Detached ❑SFR-Attached .Duplex ❑Multi-Family-#of Units; ❑C• mercial El Industrial <br /> Type of Project: ID New DAddition EIRemodel ❑Repair OT.I. ❑Sign ❑Sprinkler ■• --:. on OChange of Use <br /> DESCRIPTION OF WORK: <br /> Install one exhaust fan and connecting ductwork to exhaust air out of two below-grade inspection pits,, <br /> ASSOCIATED BUILDING PERMIT#(if applicable,: <br /> x 0y <br /> ,;Type of Project: _New _ Addn X Alteration_Repair Type of Project: New _Addn ^Alteration _Repair <br /> #of List of Fixtures #of List of Fixtures #°f List of Fixtures #°f List of Fixtures <br /> Fixtures Fixtures _ Fixtures Fixtures <br /> A/C—Air Handling Units t Heat Pump Toilet Backflow Preventer(Inside Bldg) <br /> Forced Air Systems r Unit Heater Bathtub Urinal <br /> Gas Piping Boiler °_ Lavatory(Wash-Basin) i€nktng Fountain <br /> Water Heater Refri• geration Shower Floor Drain <br /> @ Gas Fireplace Wood Stove;, Kitchen.Sink&Disposal Grease Trap <br /> I_ Gas Range f . Ducting a Dishwasher Roof Drains <br /> ',Clothes Dryer Hookups 1 Other,exhaust Clothes Washer Medical Gas <br /> Range Hood ... fan Water Heater Other: <br /> 1 Exhaust Fan Sink(Service/Bar/Mop/etc.) Other <br /> R 7 <br /> ^. 0. 0 -0R7...w....1.- .... f SYXT ,_.«< .. .,. , <br /> Number of Heads <br /> ACKNOWLEDGEMENT:t 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,slate,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.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 comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> PE.. <br /> -3 - E 11 x '4--() \ -- Og � <br /> Owner/At4h. .;d Agent Signature Date (Revised 9123/2016) t <br />