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� PERMIT APPLICATIO <br /> BUILDINgIONIECHANICAL / PLUMBING / SIGN PRINKLER / 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 SITE ADDRESS:1 620 W Marine View DR PROPERTY TAX#: <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Diane Symms TENANT BUSINESS NAME(Commercial): <br /> OWNER MAILING ADDRESS: STREET1 620 W Marine View DR <br /> cTY Everett STATE WA ZIP 98201 <br /> OWNER PHONE: 425 740-3161 OWNER EMAIL:dlaneS@IOmbardiSltallan.COm <br /> CONTRACTOR NAME:SCOtt Long <br /> CONTRACTOR ADDRESS: STREET9116 E Sprague Ave #547 <br /> CITY Spokane STATE WA ZIP 99206 <br /> CONTRACTOR PHONE:509-342-1755 CONTRACTOR EMAIL:Scott.long@ Struxureoutdoor.Corf1 <br /> CONTRACTOR LICENSE#(REQUIRED):STRUXOW81 2MB CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 62745 <br /> PRIMARY CONTACT: ❑OWNER El CONTRACTOR 0 OTHER (Please Specify) <br /> CONTACT NAME: CONTACT PHONE:509-342-1755 <br /> Scott Long CONTACT EMAIL:Scott.long@struxureoutdoor.Com <br /> BUILDING INFORMATION <br /> Existing Use of Building:Resturant Contract Price of Work: $90,0000 <br /> Proposed Use of Building:Resturant Heat Source: ❑Gas DElectric DOther <br /> BUILDING USE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-# Units _❑✓Commercial ❑Accessory Structure <br /> Type of Project: ❑New ❑✓Addition ❑Remodel ❑Repair ❑T.l. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: Our product is an open air patio cover (pergoloa). We are adding it to the space so that the owner can <br /> use the outdoor space for dinning in compliance with Covid-19 restrictions. <br /> ASSOCIATED BUILDING PERMIT#(if applicable) <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Fixture Fixture Fixture Fixture <br /> Count List of Fixtures 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 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 WasteNVater 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/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 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 I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> P MIT# <br /> 1/6/2021 2102 —"03 3 <br /> Owner/ uthori d Agent ignature Date (Revis 10/10/2018) <br /> �/` <br />