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MIN • PERMIT APPLICATi, <br /> lal <br /> BUILDING/MECHANICAL/PLUMBING 1 SIGN/SPRINKLER/DEMOLITION <br /> EVERETT CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> WASHINGTON (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITEADDRESS:909 Siever Ducy RD - Suite C PROPERTYTAX#: 28041200201300' <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Mazen Mahmoud TENANT BUSINESS NAME(Comm ral: Cy:0 ania <br /> OWNER MAILING ADDRESS: STREET 24227 E. Greystone Lane <br /> or( Woodwav STATE WA ZIP 98020 <br /> OWNER PHONE: (425) 773-2797 OWNER EMAIL mazenm@comcast . net ~ <br /> CONTRACTOR NAME: B C C I L t d <br /> CONTRACTOR ADDRESS: STREET 21117 5th Ave W <br /> CITY Bothell STATE WA ZIP 98021 <br /> CONTRACTOR PHONE: (425) 750-3927 CONTRACTOR EMAIL: chuckcross@bcciltd. co <br /> CONTRACTOR LICENSE#(REQUIRED): ` )C' li ) ' OF EVERETT BUSINESS LICENSE#(REQUI D) <br /> PRIMARY CONTACT: ❑OWNER E CONTRACTOR El OTHER(Please Specify) <br /> CONTACT NAME: Chuck Cross CONTACT PHONE: (425) 750-3927 <br /> CONTACT EMAIL: chuck cross @ b cc i l t d. c om <br /> BUILDING INFORMATION <br /> Existing Use of Building: Vacant Retail M Contract Price of Work:$ 90, 000 . 00 <br /> Proposed Use of Building: Restaurant $' Heat Source: OGes DElectric DOther <br /> BUILDING USE: ©SFR ❑Townhouse ODuplex DADU OMulti-Family-#Units: ®Commercial DAccessoStructure .� <br /> Type of Project: ONew DAddition ❑Remodel ❑Repair tT.i. DSign DSprinkler ❑Demolition DChange of Use <br /> DESCRIPTION OF WORK: <br /> Initial Tenant Build out of existing vacant retail space to establish use <br /> as B restaurant -and occupy per plans . <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Fixture FJzaae Fixture Fixture <br /> Count List of FixturesList of Fixtures <br /> Count List of Fixtures Count List of Fixtures Count <br /> A/C—Air Handling Units Gas Piping Backflow Preventer(Inside Bidgi Shower,Tub,or Combo <br /> Boiler Gas Range Clothes Washer Sink-Commercial(3-camp,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 Ventilatior Floor Drain Toilet <br /> Exhaust Hood(Type I) (Not Heat/AC system) Hose Bibb Urinal <br /> Exhaust Hood(Type II) Water Heater interceptor-Grease Waste/Water Piping Repair <br /> Exhaust Hood(Residential Wood Stove Interceptor-Sand/Oil ,Water Service(behind mete <br /> Forced Air Systems Other: Medical Gas Water Valves or Fixtures <br /> Gas Fireplace/Insert/Log _ 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 1 No.of Heads <br /> ACKNOWLEDGEMENT:I have reviewed this application end 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 i comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> PERM <br /> Own .,.. ..71..,„,.., 774....4„- 377/ /.. .,t2e) <br /> er/ uthorized Agent Signature Date (Revised 10/10/2018) <br /> lI <br /> y <br />