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grr PERMIT APPLICATIOII <br /> BOILDINmdVIECHANICAL / PLUMBING / SIGN.- PRINKLER/ DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 1 FAX 425-257-8857 l(E)everetteps@everettwa.gov l www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS:6727 Evergreen Way PROPERTY TAX#:00392900500800 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Albertson's Stores Sub LLC TENANT BUSINESS NAME(Commercial): Big Lots <br /> OWNER MAILING ADDRESS: STREET 250 Parkcenter Blvd. <br /> CITY Boise STATE ID zip 83706 <br /> OWNER PHONE: OWI)l R EMAIL: <br /> CONTRACTOR NAME:7‹.... <br /> — lQ_05:044,C..-12-- C,,k <br /> CONTRACTOR ADDRESS: STREET <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> CONTRACTOR LICENSE#(REQUIRED) 0QsR( CITY OF EVERETT BUSINESS LICENSE#(REQUIRED):C O(-( kc <br /> PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR 0 OTHER(Please Specify) Expediter <br /> CONTACT NAME: CONTACT PHONE:949.582.3735 <br /> Mary Ryan CONTACT EMAIL:mary©permitresources.com <br /> BUILDING INFORMATION r1/� <br /> Existing Use of Building:M Contract Price of Work: $ /-0( V 00 <br /> Proposed Use of Building:M Heat Source: DGas DElectric DOther <br /> BUILDING USE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑✓Commercial ❑Accessory Structure <br /> Type of Project: ❑New DAddition Remodel ❑Repair ❑✓T.I. ❑Sign Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: Permit for shelving units in (E) space. <br /> 1'Yia1C • 12 —u u <br /> OPP4 -01) + <br /> ASSOCIATED BUILDING PERMIT#(if applicable): \IF=5", C? 1 W)1 ` ` 0 Z� <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Fixture Fixture Fixture Fixture <br /> Count List of Fixtures Count List of Fixtures Count List of Fixtures Count List of Fixtures <br /> A/C—Air Handling Units Gas Piping Backflow Preventer(Inside Bldg) Shower,Tub, or Combo <br /> Boiler Gas Range Clothes Washer Sink-Commercial(3-comp,prep,floor) <br /> Clothes Dryer Heat Pump&Ductless Dishwasher Sink-Residential(kitchen,bath,bar) <br /> Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility,laundry,mop <br /> Exhaust Fans(Residential) Commercial Ventilation Floor Drain Toilet <br /> Exhaust Hood(Type I) (Not Heat/AC system) Hose Bibb Urinal <br /> Exhaust Hood(Type II) Water Heater Interceptor-Grease _Waste/Water Piping Repair <br /> Exhaust Hood(Residential) Wood Stove Interceptor-Sand/Oil _Water Service(behind meter) <br /> Forced Air Systems Other: Medical Gas Water Valves or Fixtures <br /> Gas Fireplace/InserULog Roof Drains Water Heater <br /> SPRINKLER/SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other: <br /> Water Suppression System No.of Heads <br /> Chemical Suppression System No.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/comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> i <br /> PER # I <br /> CI. .r . 1/9/19 02/A 4r <br /> Owne orized Agent tire Date (Revised 10/10/2018) ( <br />