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• PERMIT APPLICATIOP <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 l(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS:607 Riverside Rd Ste 130 Everett, WA 98201 PROPERTY TAX#:29050800402600 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Glacier Owner LLC TENANT BUSINESS NAME(Commercial): Canteen Warehouse <br /> OWNER MAILING ADDRESS: STREET9 West 57th St. <br /> CITY NY STATE NY ZIP 1 001 0 <br /> OWNER PHONE: 302 338-9130 OWNER EMAIL: MFS-US-ENTITYSERVICES@MAPLES.COM <br /> CONTRACTOR NAME:Berry Sign <br /> CONTRACTOR ADDRESS: STREET5002 S Washington St <br /> CITY Tacoma STATE WA ZIP 98409 <br /> CONTRACTOR PHONE:253 830-3600 CONTRACTOR EMAIL:mikel@berrysign.com <br /> CONTRACTOR LICENSE#(REQUIRED):Berryss857b7 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 024786 <br /> PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:253 830-3600 <br /> Mike Lee CONTACT EMAIL:MIkel@berrysign.com <br /> BUILDING INFORMATION <br /> Existing Use of Building:Commercial warehouse Contract Price of Work: $4500 <br /> Proposed Use of Building: Heat Source: ❑Gas ❑Electric ❑Other <br /> BUILDING USE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: Commercial ❑Accessory Structure <br /> Type of Project: :New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑✓Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: Install one set of non-illuminated channel letters onto fascia <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 /> A/C-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/InserULog 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 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#6.30.2021 32. 10 f-1 <br /> - OO <br /> Owner/Authorized Agent Signature Date (Revised 10/10/2018) <br />