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PERMIT APPLICATION <br /> BUILDING/MECHANICAL/ PLUMBING/SIGN I 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 1(E)everetteps@everettwa.gov 1 www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: 2120 West Casino Road SE01613E PROPERTY TAX#: Unknown <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Franklin D.Williver TENANT NAME(If Commercial): PRECISION AUTOMATICS <br /> OWNER MAILING ADDRESS: STREET 16743 32nd Avenue NE <br /> CITY Lake Forest STATE WA ZIP 98155 <br /> OWNER PHONE: N/A OWNER EMAIL: N/A <br /> CONTRACTOR NAME: TBD <br /> CONTRACTOR ADDRESS: STREET TBD <br /> crry TBD STATE TBD ziP TBD <br /> CONTRACTOR PHONE: TBD CONTRACTOR EMAIL: TBD <br /> CONTRACTOR LICENSE#(REQUIRED): TBD CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): <br /> PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR p OTHER(Please Specify) SAC Wireless(Site Development Company) <br /> CONTACT NAME: CONTACT PHONE: 425-652-5455 <br /> Jill Drake CONTACT EMAIL: jill.drake@sacw.com <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building:Telecommunications Site Contract Price of Work:$ 30,000 <br /> Proposed Use of Building: Same; adding Generator to the Ground Heat Source: OGas ❑Electric 17Other Diesel Fuel for Gen <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: I7Commercial ❑Industrial <br /> Type of Project: ❑New 1,71Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: <br /> New 25kW Gen and 4'x10' Concrete Pad and Wood Fenced Extension (6' High 14'-6" x 8' Wood Fence) <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 List of Fixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> NC—Air Handling Units Heat Pump _Toilet ..Backflow Preventer(Inside Bldg) <br /> Forced Air Systems Unit Heater 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 /> SPRINKLER/SUPPRESSION SYSTEM <br /> 'Chemical or Water I No.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 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 •a-Contractors . 8.2 -CW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> Jill Drake ,_L i _ /26/18 O r`�( --off 003 <br /> Owner/Authorized Age i-ig�— Date (Revised 9/23/2016) <br /> C2.- <br /> I <br />