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PERMIT APPLICATION <br /> BUILDING ECHANICAL/ PLUMBING /SIGN r— INKLER/ 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: 3003 W Casino Road D ,'1 t PROPERTY TAX#: <br /> LEGAL for new construction: Short Plat/subdivision ` `1 Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Boeing Company TENANT BUSINESS NAME(Commercial): Boeing Commerical <br /> OWNER MAILING ADDRESS: STREET 100 North Riverside <br /> cm, Chicago STATE Illinois ZIP 60606 <br /> OWNER PHONE: N/A OWNER EMAIL:N/A <br /> CONTRACTOR NAME: Puget Sound Fire Protection Inc. <br /> CONTRACTOR ADDRESS: STREET 1429 Ave D#294 <br /> CRY Snohomish STATE WA ZIP 98290 <br /> CONTRACTOR PHONE:425-252-0065 CONTRACTOR EMAIL:michael@pugetsoundfireprotection.com <br /> CONTRACTOR LICENSE#(REQUIRED):CC PUGETSF889PD CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 53696 <br /> PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:(425)252-0065 <br /> Michael Prudnick CONTACT EMAIL:michael@pugetsoundfireprotection.com <br /> BUILDING INFORMATION <br /> Existing Use of Building: Manufacturing Contract Price of Work:$30,000.00 <br /> Proposed Use of Building: Same Heat Source: ❑Gas ❑Electric ❑Other <br /> BUILDING USE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑✓Commercial ❑Accessory Structure <br /> Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑✓Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: Install Sprinkler Pipe to Relocated Environmental Booth <br /> ASSOCIATED BUILDING PERMIT#(if applicable): „__.,,_,_ <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> FixturePalate Fixture Fixture <br /> Count List of Fixtures Count List of Fixtures Count List of Fixtures Count List of Fixtures <br /> NC—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 Ventilatior 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 Other: <br /> Water Suppression System1 No.of Heads 10 <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 I comply with the State Contr .,Law 1 7 RCW and 296.200A WAC. <br /> G,c2:1"# C�'ity of Everett Official Use Only <br /> 3 <br /> ..016(7-,/ �- PE `D3 - Ok.g <br /> O .rl,4./ o ed A.ent S a re Date (Revised 10/10/2018) I <br /> I. /Io <br />