9505 19TH AVE SE SAGE HOMES NW 2021-07-13

• PERMIT APPLICATIO BUILDING i MECHANICAL / PLUMBING / SIGN i PRINKLER ! DEMOLITION EVERETT CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 WASHINGTON (P)425-257-8810 I FAX425-257-8857 i(E)everetteps@everettwa.gov i www.everettwa.gov/permits (Blue or Black Ink Only Please) - PROJECT,SITE INFORMATION PROJECT SITE ADDRESS:9505 19th Ave SE, Suite 109 PROPERTY TAX#:01056000010900 LEGAL for new construction: Short Plat/subdivision See attached Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: 9505 19th, LLC TENANT BUSINESS NAME(Commercial): \IN PO (\/� OWNER MAILING ADDRESS: STREET9505 19th Ave SE, Suite 118 c ITY Everett STATE WA ZIP 98208 OWNER PHONE: 425-609-8074 OWNER EMAIL:pemits@sagehomesnw.com CONTRACTOR NAME:Sage Homes Northwest, LLC CONTRACTOR ADDRESS: STREET Same address as above CITY STATE ZIP CONTRACTOR PHONE:425-609-8074 CONTRACTOR EMAIL:Permits@sagehomesnw.com CONTRACTOR LICENSE#(REQUIRED):( SAGEHHN932QM CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): (21 — PRIMARY CONTACT: ❑OWNER (] CONTRACTOR ❑ OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:(425)609-8074 Mike Brown CONTACT EMAIL:permits@sagehomesnw.com BUILDING INFORMATION Existing Use of Building:Office Contract Price of Work: $ Q J, 766.e" Proposed Use of Building:Office Heat Source: ❑Gas 0Electric ❑Other BUILDING USE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ZCommercial ❑Accessory Structure Type of Project: New ❑Addition ❑Remodel ❑Repair ET.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: Tenant improvement for Suite 109. Revise interior space with new office, storage and open spaces for new tenant. 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/Insert/Log 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 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, and I comply with the Stetecontractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only ...:::.\\%.,.... 14 A. • PZVUT# 2coz ....._00 , - _.,__. -._ ...-,. - n- . _ - ' 61 'c3P- Owner/Authorized Agent Signature Date v (Revise, d j0 0/2018 0 L