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4-77— PERMIT APPLICATION <br /> BUILDIN( IECHANICAL/ PLUMBING /SIGN' =RINKLER/ 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 /> (Ian or Black Ink Only PIowj PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS:5108 evergreen way suite 1A PROPERTY TAX#:290531004011500 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Ui Chon Pak c/o K properties NW TENANT BUSINESS NAME(Commercial): 52nd Glass and Vape <br /> OWNER MAIUNG ADDRESS: STREET 108 E Main St STE 202 (7+ <br /> my Monroe STATE WA ZIP 98203 <br /> OWNER PHONE: 253 549 9643 OWNER EMAIL:Kari@KpropertiesNW.com <br /> CONTRACTOR NAME:Self/Tenant <br /> CONTRACTOR ADDRESS: STREET 5108 Evergreen Way suite 1A <br /> cTry Everett STATE WA ZIP 98203 <br /> CONTRACTOR PHONE: 'CONTRACTOR EMAIL: <br /> CONTRACTOR UCENSE#(REQUIRED): CITY OF EVERETT BUSINESS UCENSE#(REQUIRED): <br /> PRIMARY CONTACT: D OWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:206 468 8037 <br /> Aamir Rai CONTACT EMAIL:raiaamir99@.- - <br /> BUILDING INFORMATIO <br /> Existing Use of Building: Retail Store Contract Price o W rk:$ 1200 <br /> Proposed Use of Building: Heat Source: ■Las OElectric DOther <br /> BUILDING USE: OSFR OTownhouse ODuplex DADU ❑Multi-Family-#Units: 0 mercial DAccessory Structure <br /> Type of Project: ONew DAddition DRemodel DRepair OT.I. OSign OSprinkler DDemolition DChange of Use <br /> DESCRIPTION OF WORK: We are attaching a sign which is 36 square feet. Attached documet has all info on it. Channel letter sign. <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Fixture pxprre Fixture Fixture <br /> Count List of Fixtures Court List of Fixtures List of Fixtures Count List of Fixtures <br /> CountNC—Air Handling Units Gas Piping Backflow Preventer(Inside Bldg) Showar,Tub,or Combo <br /> Boiler Gas Range Clothes Washer Sink-Commercial(3-comp,prep,floor) <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 WasteNVater 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/SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other: <br /> Water Suppression System No.of Heads <br /> Chemical Suppression System 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 lam 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 /> �/ PERMI <br /> A _,6L-xL �•. z a ��o� e.00 <br /> Owner!, thorized Agent Signature Da e (Revised 10/10/2018) <br />