Laserfiche WebLink
�I IIII"IP* PERMIT APPLICATION <br /> BUILDING tM CHANICAL I PLUMBING /SIGN /SPRINKLER/ DEMOLITION <br /> solla <br /> ��O^L CITY OF EVERETT PERMIT SERVICES <br /> � Mi��' 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwa.gov( www.everettwa.gov/permits <br /> (Blue or Black Ink nly Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRES . EVERGREEN WAY. EVERETT, WA. 98203 PROPERTY TAX#: 00393000001500,00393000001600 <br /> 00393fl0d00280000393000002900 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Madison Real Property LLC TENANT NAME(If Commercial): SUNRISE SERVICES,INC <br /> OWNER MAILING ADDRESS: STREET PO Box 31609 <br /> cm, Seattle STATE WA ZIP 98103 <br /> OWNER PHONE: (206)619-5555 OWNER EMAIL: toddmadison@hotmail.com . <br /> CONTRACTOR NAME: T.B.D. 0..„0 V,,,,t /,_,, illl ie <br /> fis <br /> CONTRACTOR ADDRESS: STREET <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> Q, l/ <br /> �/ <br /> CONTRACTOR LICENSE#(REQUIRED):01)j041g 41b Z;Z:r CITY OF EVERETT BUSINESS LICENSE#(REQU D). OP , <br /> PRIMARY CONTACT: I OWNER 0 CONTRACTOR 0 OTHER(Please Specify) i� <br /> CONTACT NAME: Todd Madison CONTACT PHONE: (206)619-5555 r <br /> CONTACT EMAIL: toddmadison@hotmail.com <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: � F5F— Contract Price of Work:$ 2,000,000 <br /> Proposed Use of Buildin , COMMERCIAURESIDENTIAL MIXED USE Heat Source: ❑Gas ®Electric 0 Other _ <br /> Building Type: ['SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ®Commercial 0 Industrial <br /> Type of Project: ®New ❑Addition ['Remodel ['Repair ❑T.I. ['Sign ❑Sprinkler ®Demolition ['Change of Use <br /> DESCRIPTION OF WORK: NEW CONSTRUCTION OF o - - " , ' - .DEMO EXISTING. Allanf"A- <br /> Eh b4oced ,Sc rvi ces 7 te4 i'i' (esH 4ND RES ,49 ! . -bed. <br /> J N�: <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New _ Addn _Alteration Repair Type of Project: _New _Addn Alteration _Repair <br /> #of Li of Fixtures #of List of Fixtures #of �.,•st of Fixtures #of List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> 5 A/C-Air' andiing Units 2 Heat Pump 7 Toilet Backflow Preventer(Inside Bldg) <br /> 2 Forced Air,.\stems Unit Heater 1 Bathtub \ 0 Urinal <br /> 5 Gas Piping Boiler 7 Lavatory(Wash\;. sin) 0 Drinking Fountain <br /> 2 Water Heater \ Refrigeration 3 Shower ` 10 Floor Drain <br /> 0 Gas Fireplace \ Wood Stove 3 Kitchen Sink&Dispos= 1 Grease Trap <br /> 1 Gas Range Ducting 2 Dishwasher 4 Roof Drains <br /> 2 Clothes Dryer Hookups\ Other: 2 Clothes Washer Medical Gas <br /> 1 Range Hood 20 PTAC 2 Water Heater 9 \Other:HOSE BIBS <br /> 12 Exhaust Fan 4 Sink(Service/Bar/Mop/etc.) 4er: CONDENSATION <br /> N PER CWGS:TOTAL FIXTURE UNI]S:504 <br /> SPRINKLER I SUPPRESSION - STEM <br /> DER <br /> WATER Chemical or Water (BIDDESIGN INo.of Heads -_==_ *"'=BIDDER DESIGN DURING CONSTRUCT'DN <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. Th•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 author" nder 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 C.'1 :rs Law 18.27 RCW and 296.200A WAC. <br /> ////�� City of Everett Official Use Only <br /> PE T# <br /> A111111/ , 4.c/C2_ -()S (LA <br /> Own- /Aut,ITAC/!�'--ignature ate (Revised 9/23/2016) <br /> ‘11/ <br />