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MIN PERMIT APPLICATIC <br /> BUILDING/MECHANICAL/PLUMBING /SIGN /SPRINKLER/DEMOLITION <br /> E V E R E T TCITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> WASHINGTON (P)425-257-8810 ( 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:1 1731 Airport Rd PROPERTY TAX#: 00442900402401 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: BRIDGE33 PROPERTIES I LLC TENANT BUSINESS NAME(Commercial): La Palmera <br /> OWNER MAILING ADDRESS: sTREET4001 S DECATUR BLVD SUITE 6, <br /> cnv Las Vegas STATE NV ZIP 89103 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME:Heath Northwest <br /> CONTRACTOR ADDRESS: STREET 727 South 96th St <br /> cm, Seattle STATE WA ZIP 98108 <br /> CONTRACTOR PHONE:206-623-3100 CONTRACTOR EMAIL:crystalc@heathnorthwest.com <br /> CONTRACTOR LICENSE#(REQUIRED): HEATH N 1981 JE CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 04-1617 <br /> PRIMARY CONTACT: ❑OWNER El CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE 23-3100 <br /> Crystal Canter CONTACT EMAIL:crystalc@heathnorthwest_com <br /> BUILDING INFORMATION <br /> Existing Use of Buiiding:Commercial Contract Price of Work:$55,000 <br /> Proposed Use of Building:Commercial iHeat Source: ❑Gas ❑Electric ❑Other <br /> BUILDING USE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ElCommercial DAccessory Structure <br /> Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.l.. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: Installation of(3)LED illuminated wall signs readin"La Patmera Family Mexican Restaurant& <br /> lounge" and add Green LED border lighting. <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Fixture List of Fixtures Fixture Fixture Fixture <br /> Count Count List of Fixtures Count List of Fixtures List of Fixtures <br /> Count <br /> IAfC—Air Handing 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/Insert/Log 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 I 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 I comply with the S.1- .ntr. .r, : -.I and 296.200A WAC. <br /> . ____ City of Everett Official Use Only <br /> dkil PERMIT <br /> b11a [6.0 - 0 t <br /> Owner/Authorized Agent Signature Date (Revised 10/10/2018) <br />