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PERMIT APPLICATIOI i <br /> 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 (F)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION` <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 /> CONTACTINFORMATION <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 /> • <br /> CITY Orlando STATE FL ZIP 32.801 <br /> OWNER PHONE: OWNER EMAIL: s <br /> ioi <br /> CONTRACTOR NAME: •TBD-prior tQ Permit Issuance Ia_._._ _yr::1,k :' i'?';_ i) I . • S <br /> CONTRACTOR ADDRESS: STREET <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: //_ CONTRACTOR EMAIL: <br /> CONTRACTOR LICENSE#(REQUIRED): lS` C L Q b t .K,--. ., CITY OF EVERETT BUSINESS LICENSE#(REQUIRED):LAUIJQ� <br /> PRIMARY CONTACT: ❑ OWNER ❑CONTRACTOR V OTHER (Please Specify) Architect <br /> 'CONTACT NAME: CONTACT PHONE: 425-271-1875 <br /> Howard Kimura, AIA CONTACT EMAIL: hgkimura(@comcast.net <br /> H.m <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building:Quick Serve Restaurant Contract Price of Work:$ 85,000 <br /> Proposed Use of Building: Restaurant Heat Source: OIGas DElectric DOther <br /> Building Type: DSFR-Detached ❑SFR-Attached ❑Duplex DMulti-Family-#of Units: Commercial ❑Indus$o 'Y <br /> Type of Project: ❑New DAddition ®Remodel DRepair LT.I. ❑Sign ❑Sprinkler DDemolition DChange of Use t <br /> DESCRIPTION OF WORK: �. <br /> { <br /> Remodel Dining,Service Counter,Toilet rooms,add new lighting,furniture,new floor&wall finish,replace upper exterior siding,install new wall and sigi-age , <br /> ASSOCIATED BUILDING PERMIT#(if applicable): I <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT AP PL .TION <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 I #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 i <br /> Water Heater Refrigeration Shower Floor Drain i <br /> Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap . - <br /> Gas Range Ducting Dishwasher Roof Drains <br /> Clothes Dryer Hookups ;y 2_ Other: /ace Clothes Washer Medical Gas <br /> Range Hood <br /> 9 0/ Siert Water Heater Other: <br /> i <br /> Exhaust Fan Sink (Service/Bar/Mop/etc.) Other: <br /> SPRINKLER/SUPPRESSION SYSTEM <br /> Chemical or Water I INo. of Heads �1 <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 State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> d PERMIT# Q <br /> t rj .. -: . -1 <br /> O er/Authorize. Agent ,ignature Date (Revised 9/23/2016) <br /> 0-'4' <br />