4727 EVERGREEN WAY GEORGE ORTHODONTICS 2021-02-22

41) PERMIT APPLICATIO• 121 BUILDING / MECHANICAL / PLUMBING /SIGN / SPRINKLER / DEMOLITION EVERETT CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 WASHINGTON (P)425-257-8810 I FAX 425-257-8857 I (E)everetteps@everettwa.gov I www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS:4727 Evergreen Way Everett, WA 98203 PROPERTY TAX#: 00010 LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: Michael George TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: sTREET4727 Evergreen Way crry Everett STATE WA ZIP 98203 OWNER PHONE: 425-327-1025 OWNER EMAIL:tamerongeorge@gmail.com CONTRACTOR NAME:NW Wholesale Signs CONTRACTOR ADDRESS: STREET 17201 Beaton RD SE CITY Monroe STATE WA zip 98272 CONTRACTOR PHONE:425-844-6415 CONTRACTOR EMAIL:Jason@nwsigns.com CONTRACTOR LICENSE#(REQUIRED):NWWHOS*929M9 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 53882 PRIMARY CONTACT: El OWNER I] CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:425 844 6415 Jason Taisey CONTACT EMAIL:Jason@nwsigns.com BUILDING INFORMATION Existing Use of Building:Dental Office Contract Price of Work:$19,100.00 Proposed Use of Building:Dental Office Heat Source: ❑Gas ❑Electric ElOther BUILDING USE: DSFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ElCommercial ❑Accessory Structure Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑✓Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: Installing one set single faced illuminated building sign to roof. Installing one illuminated wall sign on side of building. New wall sign will replace existing wall sign that is larger than Everett Municipal City Code. ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Fixture Fixture Fixture Fixture Count List of Fixtures Count List of Fixtures Count List of Fixtures Count List of Fixtures A/C—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/InserULog Roof Drains Water Heater SPRINKLER/SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other: Water Suppression System No.of Heads Chemical Suppression System '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 be eing 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 the State Contractors Law 18.27 RCW and 296.20 WAC. D 1 Crity of Everett rOfficial Use Only cOQ r/A o ' ed Age Sign e Date (Revised 10/10/2018) / Z