500 SE EVERETT MALL WAY B BASE FILE 2020-03-06

11.1111 PERMIT APPLICATION LIM BUILDING /MECHANICAL/PLUMBING /SIGN /SPRINKLER/ DEMOLITION E V E R E T TCITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 WASHINGTON (P)425-257-8810 1 FAX 425-257-8857 1(E)everetteps@everettwa.gov 1 www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION s PROJECT SITE ADDRESS: 500 ,!E GV torof Ai ft LJc' 3 PROPERTY TAX#:J,l o I g60305c00 for new construction: Short Plat/subdivision L5t No. Y (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: 'T(j MA5 koA5 TENANT BUSINESS NAME(Commercial): Twill Cr tat s eterkr OWNER MAILING ADDRESS: STREETrjOO SG A ca,-if-/VIA (( wo..� Qn CITY J la/ISI) �Y LA ZIP D y OWNER PHONE: 5b3'2.‘i$- Piet 8 OWNER EMAIL: t la/ISI)V. kOVtq Q. 9 itA i 1,(,per CONTRACTOR NAME: (4 CiTt4 14 D R.Tt4v/E -( °J CONTRACTOR ADDRESS: STREET 121 5 , q Gerti s+. CITY Sc ,-444-it_ STATE 4 A 1.ZIP N.`O CONTRACTOR PHONE: 2..�(p-(o Z�j�1- 3(b O CONTRACTOR EMAIL: j C�,Go 6'�G� ( 4 t t'tvt01 liAu�eP4.co CONTRACTOR LICENSE#(REQUIRED): Neq'CIrI JAI I&I$1 JE CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 41140/7 PRIMARY CONTACT: ❑OWNER El CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 25 3 -Li%- 56 51.' JuW1�� /f l-fti'>i CONTACT EMAIL: 1 CAw4-h' _VIQ, t41A iv rwe44 cowk BUILDING INFORMATION Existing Use of Building: Contract Price of Work:$ 2 WV Proposed Use of Building: Heat Source: OGas ❑Electric DOther_ BUILDING USE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ®Commercial DAccessory Structure Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. ®Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: gOtt'Ldl,a Kxl 7 9d6 c./ i —s, /-07r .s ',V 'T4' - 56-7 o'F- 0-605TIC AM LArr. - ASSOCIATED B ILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Faure Fixture Fixture Fixture Count List of Fixtures Count List of Fixtures Count List of Fixtures Count List of Fixtures NC—Air Handling Units Gas Piping Backflow Preventer(Inside Bldg) Shower,Tub,or Combo Boiler Gas Range Clothes Washer Sink-Commercial(3-comp,prep,floor) Clothes Dryer Heat Pump&Ductless Dishwasher Sink-Residential(kitchen,bath,bar) Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility,laundry,mop Exhaust Fans(Residential) Commercial Ventilation Floor Drain Toilet Exhaust Hood(Type I) (Not Heat/AC system) Hose Bibb Urinal Exhaust Hood(Type II) Water Heater Interceptor-Grease Waste/Water Piping Repair Exhaust Hood(Residential) Wood Stove Interceptor-Sand/Oil Water Service(behind meter) Forced Air Systems Other: Medical Gas Water Valves or Fixtures Gas Fireplace/Insert/Log Roof Drains Water Heater SPRINKLER/SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other: Water Suppression System No.of Heads Chemical Suppression System I No.of Heads 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 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 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, and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PER # <<izzirl cs\c I I— mi I • • thorized Agent Signature Date (Revised 10/10/2018) c--,/-;,,