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EVERETT <br />WASHINGTON <br />0 PERMIT APPLICATIOS <br />BUILDING / MECHANICAL / PLUMBING / SIGN / SPRINKLER / 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: 1800 41 ST ST , EVERETT, WA 98201-5072 <br />PROPERTY TAX #:00582201900100 & 00620800000002 <br />LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br />CONTACT INFORMATION <br />OWNER NAME: Jonathan KOShar TENANT BUSINESS NAME (Commercial): Zlply Fiber <br />OWNER MAILING ADDRESS: STREETPO Box 1127 <br />cIn Everett STATE WA zip 98206 <br />OWNER PHONE: 425-533-4015 <br />1OWNER EMAIL:Jonathan.Koshar@ziply.com <br />CONTRACTOR NAME:SUperGraphiCs <br />CONTRACTOR ADDRESS: STREET2201 15th Ave W <br />,,Ty Seattle STATE WA z,P 98119 <br />CONTRACTOR PHONE:(206) 284-2201 <br />1CONTRACTOR EMAIL:1Tlorgenm@SUpergraphlCS.com <br />CONTRACTOR LICENSE #(REQUIRED):CC SUPERL*812LK <br />ICITY OF EVERETT BUSINESS LICENSE #(REQUIRED). <br />PRIMARY CONTACT: ❑ OWNER [D CONTRACTOR ❑ OTHER (Please Specify) <br />CONTACT NAME: <br />Morgen Masciana <br />CONTACT PHONE:(206) 954-1 765 <br />CONTACT EMAIL: morgenm@supergraphics.com <br />BUILDING INFORMATION <br />Existing Use of Building: commercial <br />Contract Price of Work: $ '471 `1 <br />Proposed Use of Building: commercial <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.1. ❑✓ Sign ❑Sprinkler ❑Demolition ❑Change of Use <br />DESCRIPTION OF WORK: Updating existing 2 exterior non -electrical monument signs by entrance driveways with new logo design. <br />Removing "Frontier" logo and replacing with "Ziply Fiber" logo to left side of each side of the signs. <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 />Count <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 <br />Other: <br />Medical Gas <br />Water Valves or Fixtures <br />Gas Fireplace/Insert/Log <br />I <br />Roof Drains <br />Water Heater <br />SPRINKLER / SUPPRESSION <br />SYSTEM <br />Sewage Ejector or Sump Pump <br />Other: <br />Water Suppression System I <br />INo. of Heads <br />Chemical Suppression System I <br />INo. of Heads <br />ACKNOWLEDGEMENT. 1 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 I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />7! 4,& j (L <1i 11.18.20 <br />Owner/Autho4fzed Agent Signature Date <br />City of Everett Official Use Only <br />(Revised 1011012018) <br />