Laserfiche WebLink
PERMIT APPLICATI. i . <br /> BUILDIN—MECHANICAL/ PLUMBING /SIG 1 ' —RINKLER/ DEMOLITION <br /> '111P/0.4%//-----A <br /> Ni4 ,� CITY OF EVERETT PERMIT SERV <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> or_Black Ink Only. <br /> (Blue Please) „ PROJECT,SITE.INFORMATION ' ',. F_ v. . <br /> PROJECT SITE ADDRESS: 2510 W Casino Rd Everett WA 98204 PROPERTY TAX#: <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION '': <br /> OWNER NAME: K3 Woodinville LP TENANT NAME(If Commercial): Majestic Glove <br /> OWNER MAILING ADDRESS: STREET 2510 W Casino Rd <br /> crry Everett STATE WA ZIP 98204 <br /> OWNER PHONE: 4254071200 OWNER EMAIL: <br /> CONTRACTOR NAME: Pacific Air Control <br /> CONTRACTOR ADDRESS: STREET 1916 220th St.SE <br /> oily BothellSTATE WA ZIP 98021 <br /> CONTRACTOR PHONE: 2066826393 CONTRACTOR EMAIL: davidd@pacificaircontrol.com <br /> CONTRACTOR LICENSE#(REQUIRED): PACIFAC230P8 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 11347 <br /> PRIMARY CONTACT: ❑OWNER p CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 2063960182 <br /> David Denisiuk CONTACT EMAIL: davidd@pacificaircontrol.com <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: Contract Price of W, :$ 5) Vw <br /> Proposed Use of Building: Heat Source: ❑Gas a LI . er <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial <br /> Type of Project: ❑New ❑Addition ❑Remodel El Repair ❑T.l. ❑Sign ❑Sprinkler ❑Demolition El Change of Use <br /> DESCRIPTION OF WORK:, G�2 i� 4�� xha� S~{- Pe�e�r2 Un 411'''''i L <br /> INsleAhetp i- -F-en �r J J <br /> 8." w 211 .../1.:4. 20' a-F c)GC)-/ y --Or a C r Codedgli . <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION Y. 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 #°f 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 i Ducting Dishwasher Roof Drains <br /> Clothes Dryer Hookups Other: Clothes Washer Medical Gas <br /> Range Hood Water Heater Other: <br /> j 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.1 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 /> . :k ) /3/1 g PM"# <br /> "C()(4 <br /> Owner/Authorized Agent Signature Date (Revised 9/23/2016 <br />