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PERMIT APPLICATION <br />EVERETT <br />WASHINGTON <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: 8102 Evergreen Way <br />PROPERTY TAX #: 28050700307000 <br />LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />CONTACT INFORMATION <br />OWNER NAME: Four Corners, LLC TENANT BUSINESS NAME (Commercial): Four Corners Apartments <br />OWNER MAILING ADDRESS: STREET 19000 NE 8th Street, Suite 1200 <br />CITY Bellevue STATE WA zip 98004 <br />OWNER PHONE: 425-453-9551 <br />OWNER EMAIL: tom.neubauer@heartlandwa.com <br />CONTRACTOR NAME: Heartland Construction LLC <br />CONTRACTOR ADDRESS: STREET 10900 NE 8th Street, Suite 1200 <br />CITY Bellevue STATE WA Z,p 98004 <br />CONTRACTOR PHONE:425-453-9551 <br />CONTRACTOR EMAIL: tom.neubauer@heartlandwa.com <br />CONTRACTOR LICENSE #(REQUIRED): HEARTCL8280F <br />CITY OF EVERETT BUSINESS LICENSE #(REQUIRED): 60418 <br />PRIMARY CONTACT: ❑ OWNER ❑ CONTRACTOR❑ OTHER (Please Specify) Architect <br />CONTACT NAME: <br />Seth Terry <br />CONTACT PHONE: 206-204-0512 <br />CONTACT EMAIL: setht@johnsonbraund.com <br />BUILDING INFORMATION <br />Existing Use of Building: Vacant Contract Price of Work: $ TBD <br />Proposed Use of Building. Trash Enclosure <br />Heat Source: ❑Gas ❑Electric ❑Other n/a <br />BUILDING USE. ❑SFR ❑Townhouse ❑Duplex ❑ADU [7]Multi-Family -# Units: - ❑Commercial ❑✓Accessory Structure <br />Type of Project: ZNew []Addition❑Remodel ❑Repair LIT. 1. ❑Sin ❑Sprinkler ❑Demolition ❑Chan e of Use <br />DESCRIPTION OF WORK: "Four Corners Apartments - Trash South" -- Construct a new CMU and steel enclosure for trash <br />compactor, recycling and large item disposal areas. <br />ASSOCIATED BUILDING PERMIT # (if applicable): <br />MECHANICAL <br />PERMIT <br />APPLICATION <br />PLUMBING PERMIT <br />APPLICATION <br />Fixture <br />Count <br />List of Fixtures <br />Fixture <br />count <br />List of Fixtures <br />Fixture <br />Count <br />List of Fixtures <br />Fixture <br />Count <br />List of Fixtures <br />A/C — Air Handling Units <br />Gas Piping <br />Backflow Preventer (Inside Bldg) <br />Shower, Tub, or Combo <br />Boiler <br />Gas Range <br />Clothes Washer <br />Sink -Commercial (3-comp,prep, floor) <br />Clothes Dryer <br />Heat Pump&Ductless <br />Dishwasher <br />Sink -Residential (kitchen, bath, bar) <br />Duct System (Remodel) <br />Refrigeration <br />Drinking Fountain <br />Sink -Utility, laundry. mop <br />Exhaust Fans (Residential) <br />Commercial Ventilatior <br />(Not Heat/AC system) <br />Floor Drain <br />Toilet <br />Exhaust Hood (Type 1) <br />Hose Bibb <br />Urinal <br />Exhaust Hood (Type II) <br />Water Heater <br />Interceptor -Grease <br />Waste/Water Piping Repair <br />Exhaust Hood (Residential) <br />Wood Stove <br />Interceptor-Sand/Oil <br />Water Service (behind meter) <br />Forced Air Systems <br />Other: <br />Medical Gas <br />Water Valves or Fixtures <br />Gas Fireplace/Insert/Log <br />I <br />Roof Drains <br />Water Heater <br />SPRINKLER / SUPPRESSION <br />SYSTEM <br />Sewage Ejector or Sump Pump <br />Other. <br />Water Suppression System <br />No. of Heads <br />Chemical Suppression System <br />INo 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 />Pudding Official before being authorized under any circumstance. I am the owner, or 1 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 />re <br />1- Z I. ZoLo <br />Date <br />City of Everett Official Use Only <br />PERM? n � I I <br />(Revised 1011012018) <br />7 <br />