6502 EVERGREEN WAY THE GRAPE & GRAIN 2021-11-02

' MM 0 PERMIT APPLICATION. LI BUILDING / MECHANICAL / PLUMBING / SIGN / SPRINKLER / DEMOLITION EVERETT CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 WASHINGTON (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: 6502 Evergreen Way i Everett, WA 98203 PROPERTY TAX#:00393000001500 LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: MADISON REAL PROPERTY LLC TENANT BUSINESS NAME(Commercial): The Grape & Grain OWNER MAILING ADDRESS: STREET PO BOX 31609 CITY Seattle STATE WA ZIP 98103 OWNER PHONE: 206 619-5555 OWNER EMAIL:TODDMADISON@HOTMAIL.COM CONTRACTOR NAME:Berry Sign CONTRACTOR ADDRESS: STREET7400 Hardeson Rd C,n Everett STATE WA ZIP 98203 CONTRACTOR PHONE:2538303600 CONTRACTOR EMAIL:mikel@berrySign.com CONTRACTOR LICENSE#(REQUIRED):BERRYSS857B7 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 603454590 PRIMARY CONTACT: ❑OWNER El CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:2532325620 Mike Lee CONTACT EMAIL:mikel@berrysign.com BUILDING INFORMATION 7 Existing Use of Building:COmmerCial Contract Price of Work:$4500 Proposed Use of Building: Heat Source: OGas ❑Electric ❑Other BUILDING USE: ❑SFR ❑Townhouse ❑Duplex ❑ADU EMulti-Family-#Units: ✓❑Commercial ❑Accessory Structure Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑✓Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: Install one non-illuminated panel onto fascia ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Fixture Fixture Fixture Fixture Count List of Fixtures count List of Fixtures Count List of Fixtures Count List of Fixtures A/C—Air Handling Units Gas Piping Backflow Preventer(Inside Bldg) Shower,Tub,or Combo -Boiler Gas Range _Clothes Washer Sink-Commercial(3-comp,prep,floor) _Clothes Dryer - _Heat Pump&Ductless Dishwasher Sink-Residential(kitchen,bath,bar) Duct System(Remodel) - Refrigeration Drinking Fountain Sink-Utility,laundry,mop -Exhaust Fans(Residential) Commercial Ventilation Floor Drain Toilet - _Exhaust Hood(Type I) (Not Heat/AC system) Hose Bibb - Urinal Exhaust Hood(Type II) _ Water Heater Interceptor-Grease Waste/Water Piping Repair Exhaust Hood(Residential) Wood Stove Interceptor-Sand/Oil _ Water Service(behind meter) Forced Air Systems Other Medical Gas Water Valves or Fixtures Gas Fireplace/Insert/Log Roof Drains Water Heater SPRINKLER/ SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other Water Suppression System No.of Heads Chemical Suppression System No.of Heads 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 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 Building Official before being authorized under any circumstance.I am the owner,or/am authorized by the owner of this property to perform the work for which application is made, and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only % PER IT# j�% 12.1.2020 2- J`2'W Owner/Authorized Agent Signature Date (Revised 10/10/2018)