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elp PERMIT APPLICATION <br /> BUILDING / MECHANICAL/PLUMBING /SIGN /SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> - <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 /> n <br /> PROJECT SITE ADDRESS: 909 SE EVERETT MALL WAY EVERETT WA PROPERTY TAX#: 28051800300400 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> COI 'EG1 INFO TION <br /> x'h,.. <br /> OWNER NAME: BAKERY OUTLET TENANT NAME(If Commercial): BAKERY OUTLET <br /> OWNER MAILING ADDRESS: STREET 909 SE EVERETT MALL <br /> civ EVERETT STATE WA ZIP 98208 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: NATIONAL SIGN CORPORATION <br /> CONTRACTOR ADDRESS: STREET 1255 WESTLAKE AVE N <br /> CITY SEATTLE STATE WA ZIP 98109 <br /> CONTRACTOR PHONE: 206-282-0700 CONTRACTOR EMAIL: stevez@nationalsigncorp.com <br /> CONTRACTOR LICENSE#(REQUIRED): NATIOSC031 M3 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 0003006 <br /> PRIMARY CONTACT: 0 OWNER 'CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 206-282-0700 <br /> STEVE ZAMBERLIN CONTACT EMAIL: stevez@nationalsigncorp.com <br /> .f �v"" 3��✓ �c ,�:s 1hfi 01 .r M :VA ,a' rk r ✓ t% a% u` <br /> Existing Use of Building: Contract Price of Work:$ 2400 <br /> Proposed Use of Building: Heat Source: ❑Gas ❑Electric ❑Other <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: IaCommercial ❑Industrial <br /> Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. I7Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: <br /> RELOCATE TWO SINGLE FACE ULLUMINATED SIGNS TO NEW LOCATION <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 _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 I SUPPRESSION SYSTEM <br /> 'Chemical or Water I 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 /> Building Official before being authorized under any circumstance.lam 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 /> rl/ PERMIT# <br /> 9-24-18 <br /> Owner/Authorized Agent Signature Date (Revised 9/23/2016) <br />