12902 19TH AVE SE CULACCINO PIZZA AND PASTA 2022-03-03

• • PERMIT APPLICATION 14"7 BUILDING / MECHANICAL / PLUMBING / SIGN /SPRINKLER/ DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (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:12902 Bothell Everett Hwy Suite D PROPERTY TAX#:28053000406700/2740724 LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: Katya Borisova TENANT BUSINESS NAME(Commercial): Culaccino Pizza and Pasta OWNER MAILING ADDRESS: STREET 12902 BOTHELL-EVERETT HWY STE D CITY Everett STATE WA ZIP ?gab g OWNER PHONE: 425 338 5600 OWNER EMAIL:kazalak1976@gmail.com CONTRACTOR NAME:Fastsigns- Everett CONTRACTOR ADDRESS: STREET2802 Colby Ave Cmn, Everett STATE WA zip 98201 CONTRACTOR PHONE:425.438.9350 CONTRACTOR EMAIL:Duane.Steig@Fastsigns.com CONTRACTOR LICENSE#(REQUIRED):CCFASTS**832JK CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 056308 PRIMARY CONTACT: ❑OWNER CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: Cell: 360.572.7225 or Office: 425.438.9350 Duane Steig CONTACT EMAIL:Duane.Steig@Fastsigns.com BUILDING INFORMATION Existing Use of Building:581 Eating Places(Restaurants) Contract Price of Work:$3,865 Proposed Use of Building:Pizza Restaurant Heat Source: OGas ❑Electric ❑Other BUILDING USE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure Type of Project: New ❑Addition ❑Remodel ❑Repair ✓❑T.l. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: Removing existing & Installing 1 Illuminated Wall Cabinet Sign on front facade, connecting to existing 20 amp dedicated circuit. Refacing existing illuminated wall cabinet face on back of building. 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 I •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 Contractet17-1 ,27 RCW and 29. +Ay,. //)) City of Everett Official Use Only G4G ,--(___ AO'' PER%'-'42t, IDuane StelPa 442 2f20 z"�syD _goo 2-2-2020 l L - �� Owner/Authorized Agent Signatu Date (Revised 10/10/2018)