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4rETT 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 1 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 Rd, Everett S r. l PROPERTY TAX#: 28041500100100 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Boeing (Building 45-11 ) TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 3003 W. Casino Rd <br /> CITY Everett STATE WA ZIP 98204 <br /> OWNER PHONE: 206-407-2614 OWNER EMAIL: permits@macmiller.com <br /> CONTRACTOR NAME: MacDonald Miller <br /> CONTRACTOR ADDRESS: STREET 7717 Detroit Ave SW <br /> CITY Seattle STATE WA zip 98106 <br /> CONTRACTOR PHONE: 206-407-2614 CONTRACTOR EMAIL: permits@macmiller.com <br /> CONTRACTOR LICENSE#(REQUIRED): MACDOFS98ORU CITY OF EVERETT BUSINESS LICENSE#(REQUIRED):.040665 <br /> PRIMARY CONTACT: ❑ OWNER g CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 206-407-2614 <br /> Joyce Copley CONTACT EMAIL: joyce.copley@macmiller.com <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: Manufacturing Contract Price of Work: $ 10,000 <br /> Proposed Use of Building: Heat Source: EGas Electric ❑Other <br /> Building Type: ESFR-Detached ESFR-Attached ❑Duplex ❑Multi-Family-#of Units: INCommercial ❑Industrial <br /> Type of Project: ENew DAddition ®Remodel DRepair DTA. DSign ESprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: <br /> Replacing qty (4) existing drinking fountains with new ones in same locations <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 X 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 /> A/C—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) 4 Drinking Fountain <br /> Water Heater Refrigeration Shower Floor Drain <br /> Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap <br /> Gas Range Ducting Dishwasher K_ 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 /> INumber 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 Contractors Law 18.27 RCW and 296.200A WAC. <br /> 9 �^i/ City of Everett Official Use Only <br /> -49 ) 1C 12/7/2016 TTN Q. -00(0. _0 0 <br /> Owner/Authorized Agent Signature Date (Revised 5/20/2016) <br />