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NEM � PERMIT APPLICATIqk <br /> BUILDING!�IVIECHANICAL / PLUMBING / SIG 41.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 PROJECT SITE ADDRESS:4405 Rucker Ave PROPERTY TAX#:00407800500300 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: <br /> Wallace FamilyLLC TENANT BUSINESS NAME(Commercial): The Milk House Coffee <br /> OWNER MAILING ADDRESS: STREET5101 Wilmington Ave <br /> 0-r,, Everett STATE WA z,p 98203 <br /> OWNER PHONE: 425-210-1004 OWNER EMAIL:mwally24@yahoo.com <br /> CONTRACTOR NAME:Michael Wallace (Owner) <br /> CONTRACTOR ADDRESS: STREET Same as above <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> CONTRACTOR LiCENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 62639 <br /> PRIMARY CONTACT: El OWNER ❑CONTRACTOR ❑ OTHER (Please Specify) <br /> CONTACT NAME: CONTACT PHONE:425-210-1004 <br /> Michael Wallace CONTACT EMAIL: mwally24@yahoo.com <br /> BUILDING INFORMATION <br /> Existing Use of Building:Office Contract Price of Work: $3000 <br /> Proposed Use of Building:Coffee shop/bakery Heat Source: ❑Gas DElectric ❑Other <br /> BUILDING USE: ❑SFR ❑Townhouse ❑Duplex DADU ❑Multi-Family-#Units: :_JCommercial EAccessory Structure <br /> Type of Project: New ❑Addition ❑Remodel ❑Repair ETA. ❑Sign ❑Sprinkler Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: Previous use was DELI. Repair floor drains. Bring existing floor sinks up to code with vents.Also adding a Grease interceptor. <br /> Backflow preventer for equipement. Adding 2 floor sinks, 2 floor drains, 1 mop sink. <br /> ASSOCIATED BUILDING PERMIT#(if applicable): -02Qr,q- Q°ly <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 3 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 1 Sink-Utility, laundry, mop <br /> Exhaust Fans(Residential) Commercial Ventilation 2 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/iNater 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 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 f am the owner,or I am authorized by the owner of this property to perform the work for which application is made, <br /> and 1 comply..with the Mte ContratXbrs Law 18.27 RCW and 296.200A WAC. <br /> 11 City of Everett Official Use Only <br /> / / //7'Y PERT/ 3 .(2 L� <br /> Owner/Authorized Agent Signature Date (Revised 10/10/2018) <br />