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S4 PERMIT APPLICATII I II^ BUILDING /MECHANICAL/PLUMBING /SIGN /SPRINKLER / DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everetiwa.gov/permits <br /> (Blue Or Black Ink Only Please) ._. . PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: 9930 19th Ave SE <br /> (PROPERTY TAX#: 28051800405500 <br /> LEGAL for new construction: Short Plat/subdivision See Attached <br /> Lot No. (attach copy of long legal description) <br /> CONTACT"INFORMATION <br /> OWNER NAME: National Retail Properties LP <br /> P TENANT NAME(If Commercial): Wendy's Restaurant <br /> OWNER MAILING ADDRESS: STREET 450 South Orange Ave#900 <br /> CITY Orlando r- <br /> STATE FL ZIP 32801 <br /> OWNER PHONE: <br /> OWNER EMAIL: <br /> CONTRACTOR NAME: Talp-Fifkg-t0-PecR4it-lear544a4469. ` G I Q -I-int....) <br /> CONTRACTOR ADDRESS: STREET y�}� <br /> CITY <br /> STATE ZIP <br /> CONTRACTOR PHONE: 'CONTRACTOR EMAIL: <br /> CONTRACTOR LICENSE#(REQUIRED): KST ‘�q`g? L ,CITY OF EVERETT BUSINESS LICENSE#(REQUI ED): LA 50:, LA <br /> PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR jii OTHER (Please Specify) Architect <br /> CONTACT NAME: CONTACT PHONE: 425-271-1875 <br /> Howard Kimura, AIA CONTACT EMAIL: <br /> hkimura comcast.net __j <br /> BUILDING'PERMIT APPLICATION <br /> Existing Use of Building:Quick Serve Restaurant Contract Price of Work:$_85-,000- <br /> �� .r1D il <br /> Proposed Use of Building: Restaurant <br /> Heat Source: Gas ❑Electric ❑Other <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Mufti-Family-#of Units: .x... .. <br /> Commercial ❑Indus?P�_:-_.i <br /> Type of Project: ❑New ❑Addition ®Remodel ❑Repair OT.1. Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: <br /> Remodel Dining,Service Counter,Toilet rooms,add new lighting,furniture,new floor&wall finish,replace upper exterior siding,install new wall and signage <br /> ASSOCIATED BUILDING PERMIT#(if applicable): i'( b 1 (D -(Oc� <br /> MECHANICAL PERMITAP:PLICATIOIt • . <br /> PLtyM13ING PERMIT APPLICATION <br /> Type of Project: New _ Addn ✓Alteration Repair Type of Project: _New Addn Alteration Repair <br /> #of #of <br /> Fixtures List of Fixtures List of Fixtures #of #of <br /> Fixtures Fixtures List of Fixtures List of Fixtures <br /> A/C-Air Handling Units Heat PumpFixtures <br /> ToiletBackflow Preventer(Inside Bldg) <br /> Forced Air Systems Unit Heater Bathtub <br /> Gas Piping Urinal <br /> Boiler Lavatory(Wash Basin) Drinking Fountain <br /> Water Heater Refrigeration Shower <br /> Gas Fireplace Wood Stove Greaseoer DrTra <br /> Gas Range Kitchen Sink&Disposal Trap <br /> Gat Ra Dryer Hookups Ducting !Dis::washer Roof Drains — <br /> Range Hood 22- Other: /4ce Clothe. Washer Medical Gas <br /> i7 <br /> Exhaust Fan , Sferf Water Heater Other: <br /> Sink(Service/Bar/Mop/etc.) Other: --.. <br /> SPRINKLER I<S;UPPIiEPSSION SY�iTE1FlE "''.' -- <br /> (Chemical or Water 1 "No. of Heads <br /> ACKNOWLEDGEMENT:1 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 /> PERMIT# ,) <br /> _.....�r_- _Ale/iii ` /O ' /' f' �, f <br /> . <br /> 0 er/Authorize. A. t ignature ��'" f I L. i - L/y., i <br /> Date (Revised 9/23/2016) <br />