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1 0 PERMIT APPLICATIOO <br /> al <br /> BUILDING / MECHANICAL / PLUMBING / SIGN / SPRINKLER/ DEMOLITION <br /> EVERETT CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> WASHINGTON (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:2621 Colby Ave., Everett, WA 98201-2921 PROPERTY TAX#:00562461201000 <br /> LEGAL for new construction: Short Plat/subdivision Ruekers 1st Plat Lot No.101.12 (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Black Diamond Hospitality Inc. TENANT BUSINESS NAME(Commercial): METRO PCS by T Mobile <br /> OWNER MAILING ADDRESS: sTREET33422 135th PL SE <br /> CITY Auburn STATE WA zip 98092 <br /> OWNER PHONE: 253.306.5580 OWNER EMAIL:mrsmoonbang@msn.com <br /> CONTRACTOR NAME:MEYER SIGN CO. INC <br /> CONTRACTOR ADDRESS: STREET2608 WHY 99 SOUTH <br /> cm, MOUNT VERNON STATE WA ZIP 98273 <br /> CONTRACTOR PHONE:360.424.1325 CONTRACTOR EMAIL:PERMITS@MEYERSIGN.COM <br /> CONTRACTOR LICENSE#(REQUIRED):MEYERSC83238 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 57310 <br /> PRIMARY CONTACT: ❑OWNER CI CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:360.424.1325 <br /> CHAZ DUGAW CONTACT EMAIL:PERMITS@MEYERSIGN.COM <br /> BUILDING INFORMATION <br /> Existing Use of Building:COMMERCIAL Contract Price of Work:$8000 <br /> Proposed Use of Building:RETAIL SALES Heat Source: ElGas DElectric ❑Other <br /> BUILDING USE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: _ ✓❑Commercial ❑Accessory Structure <br /> Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.l. ❑Sign ❑Sprinkler ElDemolition ❑Change of Use <br /> DESCRIPTION OF WORK: REMOVE AND REPLACE EXISTING SIGNAGE ON STORE FRONT WITH UPDATED LOGO SIGN. <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Fixture Fixture Fixture Fixture <br /> Count List of Fixtures count List of Fixtures Count List of Fixtures Count List of Fixtures <br /> A/C—Air Handling Units Gas Piping Backflow Preventer(Inside Bldg) Shower,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 Waste/Water Piping Repair <br /> l)_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.1 am the owner,or/am authorized by the owner of this property to perform the work for which application is made, <br /> and I comply with the Sta Contractors Law 18.27 ROW and 296.200A WAC. <br /> f--- . City of Everett Official Use Only <br /> PERMIT ) `-`-'L/ I 0 08 I <br /> Chaz Dugaw �°;;,�u <br /> Owner/Authorized Agent Signature Date (Revised 10/10/2018) -----,, <br />