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PERMIT APPLICATION <br /> BUILDING / MECHANICAL/ PLUMBING /SIGN / SPRINKLER / DEMOLITION <br /> ^� CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET.EVERETT,WA 98201 <br /> (P)425-257-8810 1 FAX 425-257-8857 1(E)everetteps@everettwa.gov I 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#: Parcel#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 /> OWNER MAILING ADDRESS: STREET 7101 MLK Jr Way S,Suite 220 <br /> CITY Seattle STATE WA ZIP 98118 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: Commercial Property Maintenance <br /> CONTRACTOR ADDRESS: STREET 1509 Bonneville Ave,Suite A MA11.,46: P 0 QUO)' ll MI, SNoalmisH, wA 9$L91 <br /> cITr Snohomish STATE WA ZIP 98290 <br /> CONTRACTOR PHONE: (360)863-6705 CONTRACTOR EMAIL: stapert@cpmnw.com <br /> CONTRACTOR LICENSE#(REQUIRED): CC COMMECC102L1 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 027989 <br /> PRIMARY CONTACT: ❑OWNER ®CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: Jon Chacon CONTACT PHONE: (206)661-4320 <br /> CPM,Project Manager <br /> CONTACT EMAIL: jchacon@cpmnw.com <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: Retail Contract Price of Work: $ 150,000.00 <br /> Proposed Use of Building: Grocery 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.I. ❑Sign ❑Sprinkler ®Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: <br /> Demo the existing space to create a grey shell as requested by the potential tenant. <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 /> Fixtures List of Fixtures Fixtures List of Fixtures Fixtures List of Fixtures Fixtures List of Fixtures <br /> A/C—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 unth ny circumstance.I am the owner.or!am authorized by the owner of this property to perform the work for which application is made. <br /> ioo <br /> and!comply with the State C.•tractors - 8.27 RCW and 296.200A WAC. <br /> L 1 q Q lCity <br /> Qof Everett Official— Use Only <br /> PER <br /> 6/IS//Y CSOttVJ — a36 <br /> Owner/Authori d Ag-n gnature Date (Revised 9/23/2016) <br />