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PERMIT APPLICATION <br />EVERETT <br />WASHINGTON <br />BUILDING / MECHANICAL I PLUMBING / SIGN / SPRINKLER / 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 />(Oluo Ili Bbmk ink Only IPWwAii PROJECT SITE INFORMATION <br />PROJECT SITE ADDRESS:10200 1 9th Ave SE, Everett WA 98208 <br />1PROPERTY TAX #: <br />LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br />CONTACT INFORMATION` <br />OWNER NAME: COStCO TENANT BUSINESS NAME (Commercial): GOSti <br />OWNER MAILING ADDRESS: STREET 10200 19th Ave SE <br />c,n Everett STATE WA z,, 98208 <br />OWNER PHONE: <br />OWNER EMAIL: <br />CONTRACTOR NAMERermai Engineering Inc <br />CONTRACTOR ADDRESS: sTREET2945 NE Argyle ST. <br />CITY Portland STATE OR Z,p 97211 <br />CONTRACTOR PHONE:5032498190 <br />1CONTRACTOR EMAIL: and reW.lam@permacold.COnl <br />CONTRACTOR LICENSE #(REQUIRED):PERMAE1077RO <br />CITY OF EVERETT BUSINESS LICENSE#{REQUIRED): <br />PRIMARY CONTACT: ❑ OWNER Il CONTRACTOR ❑ OTHER (Please Specify) <br />CONTACT NAME: <br />Andrew Lam <br />CONTACT PHONE:503-249-8190 <br />CONTACT EMAIL:andrew,lam@permacold.com <br />BUILDING INFORMATION <br />Existing Use of Building: Warehouse store <br />Contract Price of Work: <br />Heat Source: ❑Gas ❑Electric []Other <br />Proposed Use of Buildin :No change <br />BUILDING USE: ❑SFR ❑Townhouse ❑Du lex ❑ADU ❑Multi -Family- # Units: ✓❑Commercial ElAccessory Structure <br />Type of Pro'ect: []New ❑Addition ❑✓ Remodel ❑Repair LIT. 1. ❑Sin ❑Sprinkler []Demolition ❑Chan, e of Use <br />DESCRIPTION OF WORK: Install and pipe new refrigeration equipment. Demo old equipment. <br />ASSOCIATED BUILDING PERMIT # if applicable): <br />MECHANICAL <br />PERMIT <br />APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Fixture <br />Count <br />List of Fixtures <br />Fixture <br />count <br />List of Fixtures <br />Fixture <br />Count <br />List of Fixtures <br />Fixture <br />Count <br />List of Fixtures <br />A/C - Air Handling Units <br />Gas Piping <br />Backflow Preventer (Inside Bldg) <br />Shower, Tub, or Combo <br />Boiler <br />Gas Range <br />Clothes Washer <br />Sink -Commercial (3-comp,pre ,floor) <br />Clothes Dryer <br />k4eat Pw:gpBDuctless <br />Dishwasher <br />Sink -Residential (kitchen, bath, bar) <br />Duct System (Remodel) <br />Refrigeration <br />Drinking Fountain <br />Sink -Utility, laundry, mop <br />Exhaust Fans (Residential) <br />Commerci entilatio <br />(Not HeatiAC system) <br />Floor Drain <br />Toilet <br />Exhaust Hood (Type 1) <br />Hose Bibb <br />Urinal <br />Exhaust Hood (Type II) <br />Water Heater <br />Interceptor -Grease <br />WasteiWater Piping Repair <br />Exhaust Hood (Residential) <br />Wood Stove <br />Interceptor-Sand/Oil <br />Water Service (behind meter) <br />Forced Air Systems <br />Other: <br />Medical Gas <br />Water Valves or Fixtures <br />Gas Fireplace/InserULog <br />Roof Drains <br />Water Heater <br />SPRINKLER / SUPPRESSION <br />SYSTEM <br />Sewage Ejector or Sump Pump <br />Other: <br />Water uppression System <br />INo. of Heads <br />Chemical Suppression System <br />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 />PERM T # <br />owner/Author zed Agent Signature da a fROV130d fWa(2018) <br />