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MINI PERMIT APPLICATION <br /> Limn <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> E Y1J E R E T TCITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> WASHINGTON (P)425-257-8810 1 FAX 425.257-8857 I(E)everetteps@everettwa.gov I w+aw.everettwagov/permits <br /> (S or Slack Ink Only Phi s ) PRajEc T SITE INFORMATION <br /> PROJECT SITE ADDRESS:15 SW Everett mall way suite E PROPERTY TAX 0:00480201101400 <br /> LEGAL for new construction:tion: Short Piatlsubdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Rosen Bel-Kiri associates LLC TENANT BUSINESS NAME(Commercial): Mariner Finance <br /> OWNER MAILING ADDRESS: sTwEETP.O.box 5003 <br /> c,r„ Bellevue shit WS BP 98009 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME:Crist sign service <br /> CONTRACTOR ADDRESS: smear 17725 93rd ave e <br /> crTv Puyallup sTkre ova ZIP 98375 <br /> CONTRACTOR PHONE:253 2507446 CONTRACTOR EMAIL:Jef_ffcitysignservice.Com <br /> CONTRACTOR LICENSE#(REQUIRED):CRISTSS811 C7CITY OFEVERETr BUSINESS LICENSE#(REQUIRE t <br /> PRIMARY CONTACT: ❑OWNER El CONTRACTOR Cl OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:253 209-6517 <br /> Tracey CONTACT EMAIL:tdash101@gmail.com <br /> BUILDING INFORMATION <br /> Existing Use of Building: Contract Price of Work:$1200.00 , <br /> Proposed Use of Building:Office/store Heat Source: ©Gas ❑Electric C1Other <br /> BUILDING USE: EISFR DCTownhousee ❑Duplex DADU OMulti-Family-#Units: 0Cornmerc iai DAccessory Structure <br /> Type of Project: ONew DAddition DRemodel CDRepair OT.:I, 1a Sign DSprinkler ©Demolition OChange of Use <br /> DESCRIPTION OF WORK: Sign install <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICALPERMIT APPLICATIOIN; PLUMBING PERMIT API►(III ATIt <br /> FixtureFtxtsrns Fixture Fixture <br /> �, List of Fixtures MS.CounList of Fixtures List of Fixtures Count Coon! List of Fixtures <br /> CouNC—Air Handling Units Gas Piping Backflow Preventer(Inside Bldg) Shower,Tub,or Combo <br /> Boiler Gas Range Clothes Washer Sink-Commercial(3-comp,prep,fioor) <br /> Clothes Dryer Heat Pump&Ductless Dishwasher Sink-Residential(kitchen,bath bar) <br /> Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility,laundry,mop <br /> Exhaust Fans(Residential) Commercial•Ventilatior Floor Drain Toilet <br /> Exhaust Hood(Type I) (Not Heat/AC system) Hose Bibb Urinal <br /> Exhaust hood(Type II) Water Heater Interceptor-Grease Waste/Water Piping Repair <br /> Exhaust Hood(Residential) Wood Stove Interceptor-Sand/Oil Water Service(behind meter) <br /> Forced Air Systems Other. Medical Gas Water Valves or Fixtures <br /> Gas Fireplace/Insert/Log 'Roof Drains Water Heater <br /> SPRINKLER I SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other <br /> Water Suppression System INo.of <br /> Chemical Suppression System 1 'No.of Heads <br /> ACKNOWLEDGEMENT:I have reviewed this application and confirm the information contained herein"'shoe and correct Work done pursuant to this permit must comply with <br /> current federal state,and boat lam The granting of 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 ham the owner;or I em authorized by the ownerof this properly to perform the work for s*ic*application is made <br /> and f comply with the State Contractors Law 18.27 RCWand 298.200A WAC. <br /> ;p N. <br /> City of Everett Official Use Only <br /> tAxc-----12......1,/ <br /> i uthor mad C:37 <br /> - f P MIT# O Co <br /> 44, //(4,,,,,nature2 Date (Rev ISC9 f&f 1 <br />