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4477- PERMIT APPLICATION <br /> BUILDING- ECHANIC-AL/ PLUMBING I SIGN f IMELER/-DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwa.gov 1 www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: 5209 Evergreen Way, Everett, WA 98203 PROPERTY TAX#: 28050600100200 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Asia First Inc. TENANT NAME(If Commercial): Grocery Outlet <br /> c/o Grocery Outlet <br /> OWNER MAILING ADDRESS: STREET 5650 Hollis Street <br /> CITY Emeryville STATE CA ZIP 99608 <br /> OWNER PHONE: (510) 704-2898 OWNER EMAIL: thaghayegh@cfgo.com <br /> ` <br /> CONTRACTOR NAME: ...--"V-1 k.cv` A(` e_,..I" 01,x,-r L <br /> CONTRACTOR ADDRESS: STREET <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): <br /> PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR ®OTHER(Please Specify) Architect <br /> CONTACT NAME: CONTACT PHONE: (913) 262-9095 <br /> Teresa Jones, BRR Architecture, Inc. CONTACT EMAIL: teresa. jones@brrarch.com <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: Retail Store Contract Price of Work:$ 150, 000 <br /> Proposed Use of Building: Retail Store Heat Source: ®Gas ❑Electric ❑Other <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ®Commercial CI Industrial <br /> Type of Project: ❑New ❑Addition ❑Remodel El Repair DTI ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: <br /> Construct new Grocery Outlet store in empty tenant space previously utilized as a retail store. <br /> ASSOCIATED BUILDING PERMIT#(if applicable): "� � j �W �{t�iLC�th r •,•v.0,MEI IS aT+ . <br /> N. <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New _ Addn _Alteration_Repair Type of Project: _New _Addn X 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 /> A/C-Air Handling Units Heat Pump 2 Toilet 1 Backflow Preventer(Inside Bldg) <br /> Forced Air Systems Unit Heater Bathtub Urinal <br /> Gas Piping Boiler 2 Lavatory(Wash Basin) 1 Drinking Fountain <br /> Water Heater f Refrigeratio Shower 1 Floor Drain <br /> Gas FireplaceWood Stove 11 Kitchen Sink&Disposal Grease Trap <br /> /Gas Range - Ducting Dishwasher Roof Drains <br /> Clothes Dr*Hookups Other: Clothes Washer Medical Gas <br /> Range Hood 1 Water Heater Other: <br /> Exhapet Fan 2 Sink(Service/Bar/Mop/etc.) Other: <br /> SPINKLER/SUPPRESSION SYSTEM <br /> Chemical or Water I No.of Heads <br /> ACKNO LEDGEM T: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 :deral,statend 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 /> uildin• o i./b-or bei . : thorized 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 /> a d I c t' IP, t ç <br /> � ;t, : i,,' actors Law 18.27 RCW and 296.200A WAC. <br /> 'ICity of Everett Official Use Only <br /> 1 ` I\ 1, , r_ �� PERMIT# <br /> () p <br /> 14 \ 10— <br /> Owner/Authorized A -nt Signature Date (Revised 9/23/2016) <br />