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PERMIT APPLICATION <br /> BUILDING/MECHANICAL I PLUMBING I <br /> 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: 5505 Evergreen Way,Everett,WA 98203 PROPERTY TAX#: 00393200100900 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: HENSRUDE SCOTT T&CHRISTY TENANT NAME(If Commercial): Caliber Collision <br /> OWNER MAILING ADDRESS: STREET 6130 Moltby Road <br /> cry Woodinville STATE WA ZIP 98102 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: Signs Plus NW <br /> CONTRACTOR ADDRESS: STREET 766 Marine Dr <br /> CITY Bellingham STATE WA ZIP 982, <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> CONTRACTOR LICENSE#(REQUIRED): SIGNSP1954LW CITY OF EVERETT BUSINESS LICENSE#(REQUIRE. : S 2.. <br /> PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR Ii OTHER(Please Specify) Agent of'Owner <br /> CONTACT NAME: CONTACT PHONE:574-232-5114 <br /> Erin Michaels CONTACT EMAIL: evm@sesbranding.com <br /> BUILDING PERMIT-APPLICATION "'' <br /> Existing Use of Building: No change Contract Price of Work:$ 19,800 <br /> Proposed Use of Building: No change Heat Source: ❑Gas ❑Electric ❑Other <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial <br /> Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.l. ®Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: <br /> Replacing existing channel letters on the west elevation,refacing existing(3)pole signs,installing(6)"Customer Parking"signs,(1)"Parts <br /> Delivery"panel,(4)"Employee Parking Only"signs,and(1)temporary banner <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 List of Fixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> NC—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 /> 'Chemical or Water I 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 /> IrG <br /> /r / PER ` - 00- <br /> Owner/Authorized Agent Signature Date (Revised 9/23t2016) <br />