5700 23RD DR W 2019-06-12 - Laserfiche WebLink

07ETT PERMIT APPLICATION BUILDING / MECHANICAL/ PLUMBING /SIGN /SPRINKLER/ DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 1 (E)everetteps@everettwa.gov I www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: 5700 23rd Dr West Everett, WA 98203 PROPERTY TAX#: 2804200200800 LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: Northshore Christian Church TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET 5700 23rd Dr W cm, Everett STATE WA ZIP 98203 OWNER PHONE: 425-273-4182 OWNER EMAIL: phart@northshorechristian.org CONTRACTOR NAME: Kirtley-Cole Associates, LLC CONTRACTOR ADDRESS: STREET 2820 Oakes Ave., Suite B CITY Everett STATE WA ZIP 98201 CONTRACTOR PHONE: 425-609-0400 CONTRACTOR EMAIL: jschwartz@kirtley-cole.com CONTRACTOR LICENSE#(REQUIRED): KIRTLAL951 BC CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 042968 PRIMARY CONTACT: V OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 425-273-4182 Patrick Hart, Facilities Manager CONTACT EMAIL: @hart@northshorechristian.org BUILDING PERMIT APPLICATION Existing Use of Building:Church/School Contract Price of Work: $$370,000 'Proposed Use of Building: Heat Source: PiGas ❑Electric ❑Other Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: 0Commercial ❑Industrial Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: Convert existing space into restrooms & storage. ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATIO�NV PLUMBING PERMIT APPLICATION Type of Project: _New Addn ✓AlterationRepair Type of Project: _New . Addn _Alteration _Repair #of List of Fixtures ` of List of Fixtures #of List of Fixtures #° List of Fixtures Fixtures Fi Fixtures fres A/C—Air Handling Units r % Heat Pump 10 Toilet ("Q� Backflow Preventer(Inside Bldg) Forced Air Systems � Unit Heater Bathtub l Urinal Gas Piping `';>/ Boiler 6 Lavatory(Was .B j Drinking Fountain Water Heater, Refrigeration Shower `>. e 2 Floor Drain Gas Fireple Wood Stove Kitchen S i ' sal Grease Trap Gas Rang / Ducting Dishwash Roof Drains Clothes,La'fyer Hookups Other: Clothes.Washer Medical Gas Rang>�Hood Water Heater Other: 2aust Fan Sink(Service/Bar/Mop/etc.) Other: SPRINKLER/ SUPPRESSION SYSTEM Chemical or Water ' No.of Heads 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 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 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, and I comply with the State Contractors Law 18.27 RCW and 296,200A WAC. City of Everett Official Use Only filfbig V4I. 6/28/19 PERM J I ,r (J -DU ` Owner/Authorized Agent Signature Date (Revised 9/23/2016) lb