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10200 19TH AVE SE COSTCO BAKERY 2019-11-15
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10200 19TH AVE SE COSTCO BAKERY 2019-11-15
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Last modified
11/15/2019 9:57:19 AM
Creation date
11/15/2019 9:56:45 AM
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Address Document
Street Name
19TH AVE SE
Street Number
10200
Tenant Name
COSTCO BAKERY
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lirr%/—_ PERMIT APPLICATION <br /> BUILDIR MECHANICAL/ PLUMBING /SIGN -SPRINKLER/ DEMOLITION <br /> '4117-14 <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.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROPERTY TAX#: <br /> PROJECT SITE ADDRESS: 10200 1 9th Ave SE <br /> LEGAL for new construction: Short Plat/subdivision_ Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Costco TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 999 Lake Drive <br /> cITY Issaquah STATE WA ZIP 98027 <br /> OWNER PHONE: 425-313-8100 OWNER EMAIL: <br /> CONTRACTOR NAME: Larry Prescott (Interstate Construction) 1/1k, 3C tak UM' O 1ittL. <br /> CONTRACTOR ADDRESS: STREET 437 29th Street NE Suite F <br /> cr, Puyallup STATE WA ZAP 98372 <br /> CONTRACTOR PHONE: 253-435-0949 CONTRACTOR EMAIL: Tarryp©interstateconstructiongro .Com <br /> CONTRACTOR LICENSE#(REQUIRED): I NTERCG974QR CITY OF EVERETT BUSINESS LICENSE#(REQUIRE : 1 <br /> PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR Y'OTHER(Please Specify) Project Architect \\,......_________.„. <br /> CONTACT NAME: CONTACT PHONE: 206-962-6831 <br /> Kayla Kerscher CONTACT EMAIL: kayla.ke.s er(a'Tc12.com <br /> BUILDING PERMIT APPLICATION( 1 I <br /> Existing Use of Building: Contract Price of Wor • -0. I <br /> Proposed Use of Building: No Change Heat Source: ❑Gas( ❑Electri CI Other <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: `., ViCommercial ❑Industrial <br /> Type of Project: ❑New DAddition ❑Remodel El Repair l4T.I. ❑Sign El Sprinkler ❑Demolition El Change of Use <br /> DESCRIPTION OF WORK: <br /> Bakery Equipment Upgrades-(31HobartOvens (1) obartPrroof BoxExhaust Fan (4)Transfer Fan (1) Pit Washer <br /> ASSOCIATED BUILDING PERMIT#(if applicable): 9'`— <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New ✓ Addn _Alteration _Repair Type of Project: New _Addn ✓Alteration _Repair <br /> Fixtures List of Fixtures Fi tures List of Fixtures Fixtures List of Fixtures Fiuxtof <br /> List of Fixtures <br /> 0 A/C—Air Handling Units 0 Heat Pump 0 Toilet 0 Backflow Preventer(Inside Bldg) <br /> 0 Forced Air Systems 0 Unit Heater 0 Bathtub 0 Urinal <br /> 3 Gas Piping 0 Boiler 0 Lavatory(Wash Basin) 0 Drinking Fountain <br /> 0 Water Heater 0 Refrigeration 0 Shower 3 Floor Drain <br /> 0 Gas Fireplace 0 Wood Stove 2 Kitchen Sink&Disposal 0 Grease Trap <br /> 0 Gas Range 0 Ducting 1 Dishwasher 0 Roof Drains <br /> 0 Clothes Dryer Hookups 3 Other:GAS OVEN 0 Clothes Washer 0 Medical Gas <br /> 0 Range Hood 1 PROOFER 0 Water Heater 0 Other: <br /> 3 Exhaust Fan 0 U Sink(Service/Bar/Mop/etc.) 0 Other: <br /> 0 0 0 <br /> SPRINKLER/SUPPRESSION SYSTEM 0 0 <br /> 0 Chemical or Water '0 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 State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> '� N1 ‘46()2/)41.b R #� (..0 -004Owner/Authorized Agent Sig ture Date .(Revise 9/23/2016) <br /> (Authorized Agent of Costco Wholesale) ) <br /> /L. <br />
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