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PERMIT APPLICATION BUILDINGIRECHANICAL/ PLUMBING /SIGN /S INKLER/ 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:2O31 Broadway, Everett, WA 98201 PROPERTY TAX#:00437941901300 LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: Long Division LLC TENANT BUSINESS NAME(Commercial): Bellevue Healthcare OWNER MAILING ADDRESS: STREET PO Box 52865 tiny Bellevue STATE WA ZIP 98015 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: ( "-e- /1/4 jyi( t) .'% titJ CONTRACTOR ADDRESS: STREET /1� \I J/ CITY d gyp"� V N STTA+TEE 1� ZIP CONTRACTOR PHONE:,Y 2 G(�. — f L p CONTRACTOR EMAIL: jet- f'l�1AJB T"7 _ E eli'w(Q t (, (,/fY . CONTRACTOR LICENSE#(REQUIRED): eVee- 7, -es CITY OF EVERETT BUSINESS LICENSE#(REQ IRED): 5.-73/10 PRIMARY CONTACT: DOWNER 0 CONTRACTOR D OTHER(Please Specify) Or tenant CONTACT NAME: CONTACT PHONE:425-258-6700 Aaron Harding CONTACT EMAIL:aharding@bellevuehealthcare.com BUILDING INFORMATION t Existing Use of Building:Commercial/Retail Contract Price of Work: $ 1.- t.-v Proposed Use of Building:No Change Heat Source: ❑Gas ❑Electric DOther 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: New wall sign (painted)36.6'x 7.6' (see attached elevation and art work mock-up) 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/InserULog Roof Drains Water Heater SPRINKLER/SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other: Water Suppression System 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 Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only IDD/a27 t5 PERMIT .n ` �O 0 yc, n Owner/Aut ' e'd Sianature Date (Revised/0/10/2018) / • I /2_