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4177. PERMIT APPLICATION■ <br /> 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 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) ; PROJECT;,SITE INFORMATION <br /> PROJECT SITE ADDRESS: 1 728 West Marine View Drive, Suite 227 PROPERTY TAX#: <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Port of Everett TENANT BUSINESS NAME(Commercial): Wash State Univ. <br /> OWNER MAILING ADDRESS: SrREEr12055 Craftsman Way, #200 ��jft,�✓iv ' f L nh:4 <br /> cn-v Everett STATE WA ZIP 98201 <br /> OWNER PHONE:808-729-7678 OWNER EMAIL: DaleG@portofeverett.com <br /> CONTRACTOR NAME: I4 ll �D Us <br /> CONTRACTOR ADDRESS: STREET <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): <br /> PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: %c,pr)Jit/ CONTACT PHONE: .2-f 7 , c >— 2?"2 <br /> CONTACT EMAIL: -7-54,7 j, „pi er::. � <br /> BUILDING INFORMATION, <br /> Existing Use of Building: Offices Contract Price of Work:$tritt --4-•ST - /4 k n $y 2 <br /> Proposed Use of Building: Offices Heat Source: ❑Gas ❑Electric ❑Other <br /> BUILDING USE: ❑SFR ❑Townhouse ❑Duplex DADU ElMulti-Family-#Units: ❑Commercial ❑Accessory Structure <br /> Type of Project: ❑New ❑Addition ✓❑Remodel ❑Repair ❑T.I. ❑Sign ESprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: Removing a bathtub, toilet and sink from bathroom; cap the drains and pipes <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Fixture Fixture Fixture Fixture <br /> Count List of Fixtures Count List of Fixtures Count List of Fixtures Count List of Fixtures <br /> A/C—Air Handling Units Gas Piping Backflow Preventer(Inside Bldg) Shower,Tub,or Combo <br /> Boiler Gas Range Clothes Washer Sink-Commercial(3-comp,prep,floor) <br /> Clothes Dryer Heat Pump&Ductless Dishwasher Sink-Residential(kitchen,bath,bar) <br /> Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility,laundry,mop <br /> Exhaust Fans(Residential) Commercial Ventilation Floor Drain Toilet <br /> Exhaust Hood(Type I) (Not Heat/AC system) Hose Bibb Urinal <br /> Exhaust Hood(Type II) Water Heater Interceptor-Grease Waste/Water Piping Repair <br /> Exhaust Hood(Residential) Wood Stove Interceptor-Sand/Oil Water Service(behind meter) <br /> Forced Air Systems Other: Medical Gas Water Valves or Fixtures <br /> Gas Fireplace/Insert/Log Roof Drains Water Heater <br /> SPRINKLER/SUPPRESSION SYSTEM Sewage Ejector or Sump Pump d`�i Other: of (-)/ <br /> Water Suppression System No.of Heads tt <br /> Chemical Suppression System 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 1 comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> PERMIT <br /> "722-)/ZCT (100 — 00 q <br /> Owner/Authori ed gent Signature Date (Revised 10/10/2018) <br />