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PERMIT APPLICATION• <br /> BUILDING / MECHANICAL / PLUMBING / SIGN /SPRINKLER/ DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 I FAXOLT 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:2201 100th St SW, Everett, WA 98204 PROPERTY TAX#:28041400300500 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: AUREUS LLC TENANT NAME(If Commercial): Allegion (formerly AD Systems) <br /> OWNER MAILING ADDRESS: STREET 5014 Rucker Ave <br /> CITY Everett STATE WA ZIP 98203 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME:O'Sage Signs LLC <br /> CONTRACTOR ADDRESS: STREET 15107 50th Ave E <br /> CITY Tacoma STATE WA ZIP 98446 <br /> CONTRACTOR PHONE:206.396.1036 CONTRACTOR EMAIL:osagesigns@hotmail.Com <br /> CONTRACTOR LICENSE#(REQUIRED):OSAGESL88O5A CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): ;' _ ,-? <br /> PRIMARY CONTACT: El OWNER ®CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:253.709.1096 <br /> David Benson CONTACT EMAIL:osagesigns.db@hotmail.com <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building:Commercial Contract Price of Work:$2800 <br /> Proposed Use of Building:Nochange Heat Source: ❑Gas ❑Electric ❑Other <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ®Commercial ❑Industrial <br /> Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. ®Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: Remove existing monument and wall sign, <br /> Install new monument and wall sign. <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 #°f List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> A/C—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/ SUPPRESSION SYSTEM <br /> Chemical or Water 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 /> PERMIT# <br /> BP,,w-, LL` 10/23/18 `7 <br /> Owner/Authorized Agent Signature Date (Revised 9/23/2016) <br /> z <br />