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M3 <br />PERMIT APPLICATIO <br />BUILDINAECHANICAL / PLUMBING / SIGN WRINKLER / 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: 3331 Broadway <br />PROPERTY TAX #: <br />LEGAL for new construction: Short Plat/subdivision <br />Lot No. (attach copy of long legal description) <br />CONTACT INFORMATION <br />OWNER NAME: Hopeworks Station <br />TENANT NAME (If Commercial): <br />OWNER MAILING ADDRESS: STREET 3331 Broadway <br />CITY Everett <br />STATE WA <br />zip 98201 <br />OWNER PHONE: <br />OWNER EMAIL: <br />CONTRACTOR NAME: Berry Sign Systems <br />CONTRACTOR ADDRESS: STREET 7400 Hardeson Rd <br />ciTY Everett <br />STATE WA <br />zip 98203 <br />CONTRACTOR PHONE: 425.776.8835xl 14 <br />CONTRACTOR EMAIL: tracies@berrysignsystems.com <br />CONTRACTOR LICENSE #(REQUIRED): berryss857b7 <br />ICITY OF EVERETT BUSINESS LICENSE #(REQUIRED): 024786 <br />PRIMARY CONTACT: ❑ OWNER 0 CONTRACTOR ❑ OTHER (Please Specify) <br />CONTACT NAME: <br />Tracie Skiles <br />CONTACT PHONE: 425.776.8835 X11 <br />CONTACT EMAIL: tracies@ <br />BUILDING PERMIT APPLICATION <br />Existing Use of Building: <br />Contract Price of Work: $ 58226 <br />Proposed Use of Building: <br />Heat Source: ❑Gas Electric <br />❑Other <br />Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi -Family-# of Units: ❑Commercial ❑Industrial <br />Type of Project: ❑New ❑Addition ❑Remodel ❑Repair <br />❑T.I. V]Sign ❑Sprinkler ❑Demolition <br />❑Change of Use <br />DESCRIPTION OF WORK: <br />install 3 non -lit si g g n and 6 wall signs <br />ASSOCIATED BUILDING PERMIT # (if applicable): <br />�. ,q° <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New Addn _Alteration Repair <br />Type of Project: _New _Addn <br />_Alteration _Repair <br /># of <br />Fixtures <br />List of Fixtures <br /># of <br />Fixtures <br />List of Fixtures <br /># of <br />Fixtures <br />List of Fixtures <br /># of <br />Fixtures <br />List of Fixtures <br />A/C —Air Handling Units <br />Heat Pump <br />Toilet <br />Backflow Preventer (Inside Bldg) <br />Forced Air Systems <br />Unit Heater <br />Bathtub <br />Urinal <br />Gas Piping <br />Boiler <br />Lavatory (Wash Basin) <br />Drinking Fountain <br />Water Heater <br />Refrigeration <br />Shower <br />Floor Drain <br />Gas Fireplace <br />lWood Stove <br />Kitchen Sink & Disposal <br />Grease Trap <br />Gas Range <br />Ducting <br />Dishwasher <br />Roof Drains <br />Clothes Dryer Hookups <br />Other: <br />Clothes Washer <br />Medical Gas <br />Range Hood <br />Water Heater <br />Other: <br />Exhaust Fan <br />Sink (Service/Bar/Mop/etc.) <br />Other: <br />SPRINKLER <br />/ SUPPRESSION <br />SYSTEM <br />Number 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 />cur%1din <br />eral, 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 />Bufficial 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 />anly with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />Agent Signature <br />City of Everett Official Use Only <br />PE IT #j (� <br />0 <br />(Revised 912312016) / <br />