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MINI • PERMIT APPLICAAAON <br /> BUILDING / MECHANICAL/ PLUMBING /SIGN / SPRINKLER / DEMOLITION <br /> EVERETT CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT.WA 98201 <br /> WASHiNGTON (PI 425-257-8810 I FAX 425-257-8857 I(EI everetteps@everettwa gov 1 www.everettwa gov/permits <br /> (Blue or Black Ink Only Pisass) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: 5208 S 2nd Ave. Everett, WA 98203 PROPERTY TAX#:00500301800202 <br /> LEGAL for new construction Short Plat/subdivision Lot No (attach copy of long legal description, <br /> CONTACT INFORMATION <br /> OWNER NAME: Len Yestal TENANT BUSINESS NAME(Commercial): Crux LLC <br /> OWNER MAILING ADDRESS: STREET C/O Ste 406 - 1230 Quayside Dr. <br /> C,Ty New Westminster sv,Ti: BC Canada z,.- V3M 6H1 <br /> OWNER PHONE: 425-359-2778 OWNER EMAIL:lyestal©maxview.com <br /> CONTRACTOR NAME:Pelayos Construction <br /> CONTRACTOR ADDRESS: STREET 15517 40th Ave W. Apt 103 <br /> crry Lynnwood STa1F WA zip 98087 <br /> CONTRACTOR PHONE: 425-772-2729 CONTRACTOR EMAIL:pelayosconstruction@gmail.com <br /> CONTRACTOR LICENSE#(REQUIRED): CCPELAYC*815BN CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 61232 <br /> PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR 0 OTHER (Please Specify) Spouse <br /> CONTACT NAME: CONTACT PHONE: 425-330-0155 <br /> Joanne Coghlan CONTACT EMAIL: jcoghlan@maxview.com <br /> BUILDING INFORMATION C� <br /> Existing Use of Building:Business Tenant Contract Price of Work:$ J V __- <br /> Proposed Use of Building:same Heat Source: OGas C]Electric DOther <br /> BUILDING USE ❑SFR D.Townhouse :_;Duplex 1ADU LiMulti-Family-#Units: JCommercial i_lAccessory Structure <br /> Type of Project: LJNew L Addition ❑Remodel Z Repair ETA, 'Sign ❑Sprinkler WilDemolition ❑Change of Use <br /> DESCRIPTION OF WORK: Demolish existing deteriorating bridge. Install new bridge by Mantle Industries. Fasten/connect bridge <br /> per structural engineering included. Dispose of existing bridge. <br /> ASSOCIATED BUILDING PERMIT#(if applicable) ?CDC- \A-►i <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Fixture List of Fixtures Fixture Fixture Fixture <br /> Count 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 Ventilation Floor Drain Toilet <br /> Exhaust Hood(Type I) (Not Heat/AC system) I lose Bibb Urinal <br /> Exhaust Hood(Type Ill Water Heater Interceptor-Grease Waste/Water Piping Repair <br /> 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/InserULog Roof Drains Water Heater <br /> SPRINKLER I 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.I am the owner.or I am authorized by the owner of this property to perform the work for which application is made, <br /> and/comply with the State Contractors Law 18.27 RCW and 296.200A WAC <br /> City of Everett Official Use Only <br /> ! PERMIT#1z2.6)(�r7_a, o <br /> Owner/Authorized Agent Signature Date (Revised 10/10/2018) <br />