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0115-17- PERMIT APPLICATIOI <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 (E)everetteps@everettwa.gov 1 www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS:3003 West Casino Road PROPERTY TAX#: <br /> LEGAL for new construction Short Plat/subdivision Lot No. _ (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: The Boeing Company TENANT NAME(If Commercial): Boeing, Building 45-620 <br /> OWNER MAILING ADDRESS: STREET PO Box 3707 MC M/C Oh-13 <br /> c r Seattle STATE WA ZIP 98124-2207 <br /> OWNER PHONE: (206) 662-0768 OWNER EMAIL: troy.j.gamba@boeing.com <br /> CONTRACTOR NAME: SR Building Services, LLC <br /> CONTRACTOR ADDRESS: STREET PO Box 989 <br /> CITY Redmond STATE WA ZIP 98073 <br /> CONTRACTOR PHONE:(425) 558-7770 CONTRACTOR EMAIL: lancedAsrbldgservices.com <br /> CONTRACTOR LICENSE#(REQUIRED): SRBUIBS*873L I CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 052921 <br /> PRIMARY CONTACT: ❑OWNER I$1 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: (425) 330-1302 <br /> Mike Campbell, Project Manager CONTACT EMAIL: michaelc@srbldgservices.com <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: Office Contract Price of Work: $ 82,05 1 <br /> Proposed Use of Building: Office Heat Source: ❑Gas ❑Electric ❑Other <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: K1 Commercial ❑Industrial <br /> Type of Project: ❑New DAddition DRemodel ®Repair ❑T.l. DSign DSprinkler ❑Demolition DChange of Use <br /> DESCRIPTION OF WORK: Overlay existing plywood deck and roof system with cover board and 50 mil PVC single-ply <br /> membrane in accordance with manufacturer's specifications. <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION I 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 SYSTEM <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 Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> 1(00-1-`ni <br /> Owner/Authorized Agent Signature Date (Revised 5/20/2016) <br />