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PERMIT APPLICATIO <br /> / 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:1501 Walnut Street , EVERETT, WA 98201 PROPERTY TAX#:00556331500100 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Prayosha Incorporated TENANT BUSINESS NAME(Commercial): Lucky Market <br /> OWNER MAILING ADDRESS: STREET419 170th PI SE <br /> ciTY Mill Creek STATE WA zip 98012 <br /> OWNER PHONE: 425-773-0180 OWNER EMAIL:nilesh.baps@gmail.com <br /> CONTRACTOR NAME:TBD FeArto C,cs h'IA,LH on <br /> CONTRACTOR ADDRESS: STREET <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> CONTRACTOR LICENSE#(REQUIRED): I'E lz, O( 1 05 (i IV CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 6 21 15 <br /> PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR 0 OTHER(Please Specify) Owner's Representative <br /> CONTACT NAME: CONTACT PHONE:206.582.2573 <br /> Michael Chen CONTACT EMAIL:mchen@mcknze.com <br /> BUILDING INFORMATION <br /> Existing Use of Building:Convenience Market Contract Price of Work: $30,000 <br /> Proposed Use of Building:Utility/Carport Heat Source: ❑Gas ❑Electric DOther 1 w <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: Construction of a -150sf enclosure located in the parking lot of existing site. <br /> The enclosure will be unoccupied and non-conditioned to house distribution mechanisms. Permanent power will be pulled to <br /> the enclosure under a separate design/build permit. <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/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 /> 2/25/21 PERMIT ac3 cm_ <br /> Owner/Authorized Agent Si ature Date (Revised 10/10/2018) lJ <br />