4919 EVERGREEN WAY QFC 2019-09-05

PERMIT APPLICATION BUILDING 1 MECHANICAL/PLUMBING/SIGN I SPRINKLER/ DEMOLITION #1111111 CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 1 FAX 425-257-8857 1(E)everetteps©everettwa.gov 1 www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION ' PROJECT SITE ADDRESS: 4919 Evergreen Way, Everett, WA 98203 PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: Quality Food Centers TENANT NAME(if Commercial): OWNER MAILING ADDRESS: STREET 3701 S. Norfolk St CITY Seattle STATE WA ZIP 98118 OWNER PHONE: 206-346-3971 OWNER EMAIL:john.rehwald@kroger.com CONTRACTOR NAME: Hoover Commercial Refrigeration CONTRACTOR ADDRESS: STREET 3202 Cedardale Rd Suite C-300 CITY iV1t Vernon STATE WA ZIP 98274 CONTRACTOR PHONE: 360-445-2019 ifBfl✓iEG*C CONTRACTOR EMAIL: nancny.hcr@gmaiI.com CONTRACTOR LICENSE#(REQUIRED): 603-093-786 Y1,D'/v CiTY OF EVERETT BUSINESS LICENSE#(REQUIRED):052841 PRIMARY CONTACT: ❑OWNER r,?'CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 360-399-8052 Nancy Nygren CONTACT EMAIL: nancyny.hcr@gmail.com BUILDING PERMIT APPLICATION Existing Use of Building:grocery storecontract price of ' Proposed Use of Building: Heat Source: ❑Gas DElectric ❑Other Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: irdCommercial ❑Industrial Type of Project: ❑New ❑Addition fdRemodel ❑Repair ❑T.I. OSign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: replacing (4) dairy cases at QFC#852 ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Type of Project: _New _ Addn _Alteration _Repair Type of Project: New _Addn _Alteration Repair #of List of Fixtures #of #of #of Fixtures Fixtures List of Fixtures List of Fixtures List of Fixtures Fixtures Fixtures A/C—Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) Forced Air Systems Unit Heater Bathtub Urinal Gas PipingBoiler Lavatory(Wash Basin) Drinking Fountain Water Heater Refrigeration Shower Floor Drain Gas Fireplace Wood Stove Kitchen Sink&Disposal , Tra Gas Range p 9 Ducting Dishwasher Roof Drains Clothes Dryer Hookups Other: Clothes Washer Medical Gas Range Hood Water Heater Other: Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: SPRINKLER t SUPPRESSION SYSTEM Chemical or Water f JNo.of Heads ACKNOWLEDGEMENT:i have reviewed this application and confinn the information contained herein is true and correct.Work done pursuant to this permit must comply with ` 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 Building Official before being authorized under any circumstance.I am the owner,or/am authorized by the owner of this property to perform the worn for which application is made, and I comply with the Stale Contractors Law 18.27 RCW and 296.200A WAC. City of Evomtt Official Use Only 8—k/8 PERMIT# Owner utho Agent Signature Date (Revised 9/2312016) 67-j.