1605 SE EVERETT MALL WAY WALMART 2022-01-12

mi. 411 PERMIT APPLICATII iz 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 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: 1605 SE Everett Mall Way PROPERTY TAX#: 28051800405600 LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: Walmart Real Estate Business Trust TENANT BUSINESS NAME(Commercial): Walmart#3053 OWNER MAILING ADDRESS: STREET 2608 J Street CITY Bentonville STATE AR ZIP 72716 OWNER PHONE: 479.273.4000 OWNER EMAIL: amy.miles@pb2ae.com CONTRACTOR NAME: Place Services Inc. CONTRACTOR ADDRESS: STREET 95 Hickory Springs Industrial Drive CITY Canton STATE GA ZIP 30115 CONTRACTOR PHONE: 678.880.4777 4GONTIWTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED t I cr&�J I Bp CITY OF EVERETT BUSINESS LICENSE#(REQUI l b T PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR D OTHER(Please Specify) Architect-Permit Coordinator CONTACT NAME: CONTACT PHONE:479.878.3510 Amy Miles, pb2 architecture + engineering CONTACT EMAIL:amy.miles@pb2ae.com BUILDING INFORMATION Existing Use of Building: Mercantile-Retail Contract Price of Work:$5000.00 I Proposed Use of Building:Mercantile-Retail Heat Source: ❑Gas ❑Electric ❑Other BUILDING USE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ©Commercial ❑Accessory Structure Type of Project: ❑New ❑Addition ✓❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: Install access gates inside customer entrance(s) 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 I SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other: Water Suppression System I 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 I am authorized by the owner of this property to perform the work for which application is made, and I comply with the State Contract rs Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only LAiv2..4 : PER IT# 03.04.2020 2V 01 Owner/Authoriz ent Signature Date (Revised 10/10/2018)