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OLTPERMIT APPLICATIO <br /> BUILDIIJI'HVIECHANICAL/ PLUMBING/SIGN*RINKLER <br /> / 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 /> ltttaaaggfgt ;. . 4. " r._.. ,, , . k..g; PROJECT SITE IN:FORMATIION,,.w, <br /> PROJECT SITE ADDRESS: 3003 W Casino Rd. PROPERTY TAX#: 28041000100200 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> r t ;;` ,:, F S'CON,TACT fINFO:kMATIONZI r R E,rf`. <br /> OWNER NAME: Boeing Co TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET PO Box 3707 M/S OH-13 <br /> cITY Seattle STATE WA ZIP 98124-2207 <br /> OWNER PHONE: 425-239-7983 OWNER EMAIL: david.d.tyler@boeing.com <br /> CONTRACTOR NAME: Hoffman <br /> CONTRACTOR ADDRESS: STREET <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> CONTRACTOR LICENSE#(REQUIRED): HOFFNCC164NC CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 041705 <br /> PRIMARY CONTACT: aOWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 425-239-7983 <br /> Dave Tyler CONTACT EMAIL: david.d.tyler@boeing.com <br /> t _,; . , i . .. ,. BUILDING;PrERMIT,APPLICATION =- <br /> Existing Use of Building: N/A Contract Price of Work:$ $5,000.00 <br /> Proposed Use of Building: OFFICE Heat Source: ❑Gas ❑Electric ❑Other <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial C Industrial <br /> Type of Project: lJNew ❑Addition ❑Remodel ❑Repair 12gT.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: <br /> Building 45-112-Tenant improvement to finish existing modular office building. <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMITAPPL,ICATION:. 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 /> 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) 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 SY(STEM' <br /> Number 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 •w ;.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> 4y7 <br /> - /I - I t (q 1; 6 PERMIT# bRooq- ob6 <br /> r-. <br /> Owner/Authorized Agent Signature 4 Date (Revised 10/12/2015) <br />