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0 PERMIT APPLICATION• <br />EVERETT <br />WASHINGTON <br />BUILDING / MECHANICAL / PLUMBING / SIGN / SPRINKLER 1 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 wvvw.everettwa.gov/permits <br />(Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br />PROJECT SITE ADDRESS: 6101 Associated Blvd #101 <br />1PROPERTY TAX #: <br />LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br />CONTACT INFORMATION <br />OWNER NAME: Safeology TENANT BUSINESS NAME (Commercial): <br />OWNER MAILING ADDRESS: STREET 6101 Associated Blvd #101 <br />c,Tv Everett STATE WA Z,P 98203 <br />OWNER PHONE: <br />OWNER EMAIL: <br />CONTRACTOR NAME: Berry Sign Sytems <br />CONTRACTOR ADDRESS: STREET7400 Hardeson Rd <br />CITY Everett STATE WA ZIP 98203 <br />CONTRACTOR PHONE:4257768835 <br />CONTRACTOR EMAIL:trades@berryslgnsystems.com <br />CONTRACTOR LICENSE #(REQUIRED):berryss857b7 <br />CITY OF EVERETT BUSINESS LICENSE #(REQUIRED): 024786 <br />PRIMARY CONTACT: []OWNER 171 CONTRACTOR ❑ OTHER (Please Specify) <br />CONTACT NAME: <br />Trade <br />CONTACT PHONE:42577 68835 X114 <br />CONTACT EMAIL:tracies@berrysignsystems.com <br />BUILDING INFORMATION <br />Existing Use of Building: <br />Contract Price of Work: $9962.49 <br />Proposed Use of Building: <br />Heat Source: ❑Gas ❑Electric ❑Other <br />BUILDING USE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi -Family - # Units: ✓❑Commercial ❑Accessory Structure <br />Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑✓ Sign ❑Sprinkler ❑Demolition ❑Change of Use <br />DESCRIPTION OF WORK: install one wall sign <br />ASSOCIATED BUILDING PERMIT # (if applicable): <br />MECHANICAL <br />PERMIT <br />APPLICATION <br />PLUMBING PERMIT <br />APPLICATION <br />Fixture <br />Count <br />List of Fixtures <br />Fixture <br />cou�r <br />List of Fixtures <br />Fixture <br />Count <br />List of Fixtures <br />Fixture <br />Count <br />List of Fixtures <br />A/C — Air Handling Units <br />Gas Piping <br />Backflow Preventer (Inside Bldg) <br />Shower, Tub, or Combo <br />Boiler <br />Gas Range <br />Clothes Washer <br />Sink -Commercial (3-comp,prep,floor) <br />Clothes Dryer <br />Heat Pump&Ductless <br />Dishwasher <br />Sink -Residential (kitchen,bath,bar) <br />Duct System (Remodel) <br />Refrigeration <br />Drinking Fountain <br />Sink -Utility, laundry, mop <br />Exhaust Fans (Residential) <br />Commercial Ventilatior <br />(Not Heat/AC system) <br />Floor Drain <br />Toilet <br />Exhaust Hood (Type 1) <br />Hose Bibb <br />Urinal <br />Exhaust Hood (Type II) <br />Water Heater <br />Interceptor -Grease <br />Waste/Water Piping Repair <br />Exhaust Hood (Residential) <br />Wood Stove <br />Interceptor-Sand/Oil <br />Water Service (behind meter) <br />Forced Air Systems I <br />10ther <br />Medical Gas <br />Water Valves or Fixtures <br />Gas Fireplace/Insert/Log I <br />I <br />Roof Drains <br />Water Heater <br />SPRINKLER 1 SUPPRESSION <br />SYSTEM <br />Sewage Ejector or Sump Pump <br />Other: <br />Water Suppression System <br />I No. of Heads <br />Chemical Suppression System <br />lNo. 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 l am authorized by the owner of this property to perform the work for which application is made, <br />and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />Agent Signature <br />I City of Everett Official Use Only <br />P IT <br />ate (Revised 10/10/2018) <br />