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Ore-Tr— PERMIT APPLICATION <br /> BUILDING I 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.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: 2510 W Casino Rd #B PROPERTY TAX#: <br /> LEGAL for new construction: Short Plat/subdivision_ Lot No (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: North Pacific Holding TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 2510 W Casino Rd #B <br /> CITY Everett STATE WA ZIP 98204 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME Berry Sign Systems <br /> CONTRACTOR ADDRESS: STREET 7400 Hardeson Rd <br /> CITY Everett STATE WA ZIP 98203 <br /> CONTRACTOR PHONE: 425.776.8835X114 CONTRACTOR EMAIL: tracies@berrysignsystems.com <br /> CONTRACTOR LICENSE#(REQUIRED): berryss857b7 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED):024786 <br /> PRIMARY CONTACT: 0 OWNER CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 425.776.8835 X114 <br /> Tracie Skiles CONTACT EMAIL: tracies@berrysystems.com <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: Contract Price of Work: $ 3735 <br /> Proposed Use of Building: Heat Source: EGas ❑Electric DOther <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex DMulti-Family-#of Units: DCommercial ❑Industrial <br /> Type of Project: ❑New DAddition DRemodel DRepair ❑T.I. 14Sign DSprinkler DDemolition DChange of Use <br /> DESCRIPTION OF WORK: <br /> install 1 non-lit wall sign <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New Addn _Alteration Repair Type of Project: _New Addn Alteration Repair <br /> #of #of #of #of <br /> List of Fixtures List of Fixtures List of Fixtures List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> • <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 Water Heater Other: <br /> Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: <br /> SPRINKLER / SUPPRESSION SYSTEM <br /> Number 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 /> Buildin fficial 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 om ly with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> °/ City of Everett Official Use Only <br /> PERMIT# <br /> ( i sao8ei <br /> Owrter"/p rize Agent Signature Date (Revised 9/23/2016) <br /> 11 7_, <br />