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PERMIT APPLICATION <br />BUILDIN(OWECHANICAL / PLUMBING / SIGN•PRINKLER / 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: 15021 19TH AVENUE SE <br />PROPERTY TAX #: 2805200020300 <br />LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) COPY ATTACHED <br />CONTACT INFORMATION <br />OWNER NAME: SHENGTAI INC. - owner's rep = Richard Heide TENANT NAME (If Commercial): <br />OWNER MAILING ADDRESS: STREET 150 120th Ave NE Suite 110 <br />CITY BELLEVUE. WA 98005 STATE ZIP <br />OWNER PHONE: 485-633-2158 <br />OWNER EMAIL: rheide@shengtaiinc.com <br />CONTRACTOR NAME r` <br />_! <br />CONTRACTOR ADDRESS: STREET - S J VC�qy <br />(L, ` <br />CITY- L L STATE ��� ZIP ! L/00:s <br />CONTRACTOR PHONE: 41 2 (e i z S CH ) <br />CONTRACTOR EMAIL: 6� I o �+- - e ' t- � t . I - ✓ _ Lt k <br />CONTRACTOR LICENSE #(REQUIRED): <br />CITY OF EVERETT BUSINESS LICENSE #(RE UIRED): <br />PRIMARY CONTACT: ❑ OWNER ❑ CONTRACTOR ® OTHER (Please Specify) ARC HITEC T <br />CONTACT NAME: JENSEN-FEY ARCHITECTURE <br />8RXAN SCHLA - PF-UJ-ECT�ivf PfR <br />\ - u�ll; <br />CONTACT PHONE: 425-216-0318 x307 <br />CONTACT EMAIL: bryans@y. jensenfe com <br />BUILDING PERMIT APPLICATION <br />Existing Use of Building: N/A <br />Contract Price of Work: $ '140"OG- <br />Proposed Use of Build ingRESTAURANT/RETAIL/SALON/OFFICE <br />Heat Source: L%%IGas ❑Electric ❑Other <br />Building Type: ❑SFR-Detached ❑SFR-Attached []Duplex ❑Multi -Family-# of Units: OCommercial ❑Industrial <br />Type of Project: I-:1New ❑Addition ❑Remodel ❑Repair ❑T.l. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br />DESCRIPTION OF WORK: PROVIDE SHELL -AND ILDING AND SITE DESIGN FOR UNFINISHED <br />RESTAURANT AND ETAIL SPACE . INAL FINISHING TO BE BY OTHERS <br />UNDER SEPARATE T.. ( ll�IYF { f <br />ASSOCIATED BUILDING PERMIT # (if applicable):(W�611f- qL Vn <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project: New Addn _Alteration _Repair <br />Type of Project: New _Addn _Alteration _Repair <br /># of <br />Fixtures <br />List of Fixtures <br /># of <br />Fixtures <br />List of Fixtures <br /># of <br />Fixtures <br />List of Fixtures <br /># of <br />Fixtures <br />List of Fixtures <br />A/C - Air Handling Units <br />Heat Pump <br />Toilet <br />Backflow Preventer (Inside Bldg) <br />Forced Air Systems <br />Unit Heater <br />Bathtub <br />Urinal <br />Gas Piping <br />Boiler <br />Lavatory (Wash Basin) <br />Drinking Fountain <br />Water Heater <br />Refrigeration <br />Shower <br />Floor Drain <br />Gas Fireplace <br />Wood Stove <br />Kitchen Sink & Disposal <br />Grease Trap <br />Gas Range <br />Ducting <br />Dishwasher <br />Roof Drains <br />Clothes Dryer Hookups <br />Other: <br />Clothes Washer <br />Medical Gas <br />Range Hood <br />Water Heater <br />Other: <br />Exhaust Fan <br />Sink (Service/Bar/Mop/etc.) <br />Other: <br />SPRINKLER <br />/ SUPPRESSION <br />SYSTEM <br />Chemical or Water <br />INC. of Heads <br />ACKNOWLEDGEMENT: 1 have reviewed <br />current federal, state, and local law. The c <br />Building Official before being authorized u <br />and 1 comply with th to Contractors <br />application and confirm the information contained herein is true and correct. Work done pursuant to this permit must comply with <br />Ming of a permit only authorizes approved work and no deviations therefrom. Deviations must first be authorized in writing from the <br />r 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 />18.27 RCW and 296.200A WAC. <br />3-0-l7 <br />Owner/Authorized Agent Signature Date <br />City of Everett Official Use Only <br />PER IT # � -�o A <br />(Revised 9/23/2016) <br />