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• PERMIT APPLICATION • <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> EVERETT CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> WASHINGTON (P)425-257-8810 I FAX 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:1201 SE Everett Mall Way PROPERTY TAX#: <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: ACF Property Managment TENANT BUSINESS NAME(Commercial): Quaility Sewing&Vacuum <br /> OWNER MAILING ADDRESS: sTREEr 12411 Ventura BLVD <br /> crw Studio City STATE CA zip 98021 <br /> OWNER PHONE: 818-505-6777 OWNER EMAIL: <br /> CONTRACTOR NAME:Spencfab <br /> CONTRACTOR ADDRESS: STREET23425 53RD Ave SE <br /> cnv Bothell STATE WA zip 98021 <br /> CONTRACTOR PHONE:425-449-0277 CONTRACTOR EMAIL:spencfab@gmail.com <br /> CONTRACTOR LICENSE#(REQUIRED):SPENC**842KF CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 57836 <br /> PRIMARY CONTACT: ❑OWNER El CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:425-449-0277 <br /> Shawn Spencer CONTACT EMAIL:spencfabC•'•i ail. •• <br /> BUILDING INFORMATION ( <br /> Existing Use of Building:Retail Contract Price of ork:$650 <br /> Proposed Use of Building: Heat Source: ❑c as ❑Electric DOther <br /> BUILDING USE: DSFR ❑Townhouse ❑Duplex DADU DMulti-Family-#Units: ❑Cox ercial ❑Accessory Structure <br /> Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑✓Sign ❑Sprinkler -I emolition ❑Change of Use <br /> DESCRIPTION OF WORK: Install sign on rear elevation <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Fixture Fixture Fixture Fixture <br /> Count List of Fixtures Count List of Fixtures Count List of Fixtures Count List of Fixtures <br /> NC—Air Handling Units Gas Piping Backflow Preventer(Inside Bldg) Shower,Tub,or Combo <br /> Boiler Gas Range Clothes Washer Sink-Commercial(3-comp,prep,floor) <br /> Clothes Dryer Heat Pump&Ductless Dishwasher Sink-Residential(kitchen,bath,bar) <br /> Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility,laundry,mop <br /> Exhaust Fans(Residential) Commercial Ventilation Floor Drain Toilet <br /> Exhaust Hood(Type I) (Not Heat/AC system) Hose Bibb Urinal <br /> Exhaust Hood(Type II) Water Heater Interceptor-Grease Waste/Water Piping Repair <br /> Exhaust Hood(Residential) Wood Stove Interceptor-Sand/Oil Water Service(behind meter) <br /> Forced Air Systems Other. Medical Gas Water Valves or Fixtures <br /> Gas Fireplace/Insert/Log Roof Drains Water Heater <br /> SPRINKLER/SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other: <br /> Water Suppression System No.of Heads <br /> Chemical Suppression System I 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.lam the owner,or lam 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 EverettOfficial tUseOnly <br /> /6J�v� �X P IT <br /> J (/J <br /> Owner A orized Agent Sig ture `— Date (Revis 10/10/2018) <br /> I <br />