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,41IPPERMIT APPLICATIOL <br /> BUILDING /MECHANICAL I PLUMBING /SIGN / SPRINKLER I DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 l(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> ,,Blue olr Bla k,Ink t' nI .'Please). ...k tO::I«,CT Sfl E,iN :O M' ION. <br /> 3 , <br /> PROJECT SITE ADDRESS: 9930 19th Ave SE PROPERTY TAX#: 28051800405500 <br /> LEGAL for new construction: Short Plat/subdivision See Attached Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: National Retail Properties LP TENANT NAME(If Commercial): Wendy's Restaurant <br /> OWNER MAILING ADDRESS: STREET 450 South Orange Ave#900 <br /> CITY Orlando STATE FL ZIP 32801 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: TBD prior to Permitm _ <br /> Issuance ]4,OPru;.‘f 5tw eli . iA , 1 / DIN <br /> CONTRACTOR ADDRESS: STREET 1A64° ' g 2 ' l ll I <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: (CONTRACTOR EMAiL: e___ S <br /> CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIf ):4 t 4(o ( i' <br /> PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR Vi OTHER(Please Specify) Architect <br /> CONTACT NAME: CONTACT PHONE: 425-271-1875 <br /> Howard Kimura, AIA CONTACT EMAIL: hgkimura(C�comcast.net <br /> Bb ti4.N�IN,MttG:4'k tMttAt►, iWitti 0,N s <br /> Existing Use of Building:Quick Serve Restaurant Contract Price of Work:$ I i L�5a _ <br /> Proposed Use of Building: Restaurant Heat Source: ViGas ❑Electric DOther <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: rf7Commercial ❑Industrial <br /> T pe of Proect: ONew DAddition ❑Remodei ❑Repair ❑T.I. ►!Si•n ❑Sprinkler ❑Demolition ❑Chan•e of Use <br /> DESCRIPTION OF WORK: <br /> Install new freestanding sign "face," 4 directional signs,4 Wendy's channel signs. <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> i x . , MECHAI`1 iCAI,PERMIT APPiLNCATION <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 Heater Other: <br /> Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: <br /> Chemical or Water No. of Heeds I <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 1 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 /> 1 1,— ,r 16 City of Everett Official Use Only <br /> i <br /> i'! PE: u 1. <br /> cc <br /> 2„, ] <br /> f --7----*6--,:,-- -- __ i7i.Ty-( <br /> Owner/Auttila ized A £Sinature Date (Revised 9/23/2016) 1 <br />