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PERMIT APPLICATIOP <br /> BUILDING/MECHANICAL/PLUMBING /SIGN/SPRINKLER I DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (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: 510 W Casino Rd(Suite D),Everett WA 98204 PROPERTY TAX#: 28041300200500 <br /> LEGAL for new construction: Short Plat/subdivision_ Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: DKJ Investments 11 LLC TENANT NAME(If Commercial): DKJ Food Mart Mobil <br /> OWNER MAILING ADDRESS: STREET 2115 116th St NE <br /> cnY Marysville STATE WA ZIP 98271 <br /> OWNER PHONE: Brian Kooy(425)220-1009 OWNER EMAIL: brian.deltafuel@gmail.com <br /> CONTRACTOR NAME: Insignia Sign Inc. <br /> CONTRACTOR ADDRESS: STREET PO BOX 2849 <br /> CITY Renton STATE WA ZIP 98056 <br /> CONTRACTOR PHONE: (425)917-2109 CONTRACTOR EMAIL: steven@insigniasign.cOm <br /> CONTRACTOR LICENSE#(REQUIRED): INSIGSI062QZ CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 038029 <br /> PRIMARY CONTACT: ❑OWNER ®CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: (425)917-2109 <br /> Steven Thomson @ Insignia Sign Inc. CONTACT EMAIL: steven@insigniasign.com <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building:76 Gas Station &Food Mart Contract Price of Work:$15,000.00 <br /> Proposed Use of Building:Mobil Gas Station & Food Mart Heat Source: ['Gas ['Electric ❑Other <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ODuplex ❑Multi-Family-#of Units: ®Commercial ❑Industrial <br /> Type of Project: ONew ❑Addition ['Remodel ❑Repair ❑T.I. ®Sign ['Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: <br /> ®Replace existing 76 tenant faces in existing freestanding sign with new MOBIL faces(REFACE ONLY);Wire new L IprIf,,e faces to existing electricaijircuit;,. <br /> Mil Replace 2 existing illuminated 76 canopy signs with 2 new 1'-10"x6'-l" LED illuminated Mobil canopy signs: <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New Addn _Alteration _Repair Type of Project: _New Addn _Alteration _Repair <br /> #of List of Fixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> NC—Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) <br /> Forced Air Systems Unit Heater Bathtub Urinal <br /> Gas Piping Boiler Lavatory(Wash Basin) Drinking Fountain <br /> Water Heater Refrigeration Shower Floor Drain <br /> Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap <br /> Gas Range Ducting Dishwasher Roof Drains <br /> Clothes Dryer Hookups Other: Clothes Washer Medical Gas <br /> Range Hood Water Heater Other: <br /> Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: <br /> SPRINKLER I SUPPRESSION SYSTEM <br /> 'Chemical or Water ' No.of Heads <br /> ACKNOWLEDGEMENT:I have reviewed this application and confine 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.!am the owner,or!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 Steven `Thom on (Contractor&Agent) 03/29/19 PE # `I[ <br /> Owner/Authorized Agent Signature Date (Revised 9/23/2016) <br /> /G- <br />