1610 SE EVERETT MALL WAY 2023-02-06

® 4110 PERMIT APPLICATION. 112 BUILDING / MECHANICAL/ PLUMBING /SIGN /SPRINKLER/ 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:1610 SE Everett Mall Way PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision_ _ Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: Anthem Storage TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET1610 SE Everett Mall Way cm' Everett STATE WA ZiP 98208 OWNER PHONE:425 438-1811 OWNER EMAIL:kll@integralnw.com CONTRACTOR NAME:Berry Sign Systems CONTRACTOR ADDRESS: STREET7400 Hardeson Rd CITY Everett STATE WA ZIP 98203 CONTRACTOR PHONE:4257768835 CONTRACTOR EMAIL:traCles@berrysignsyStems.com CONTRACTOR LICENSE#(REQUIRED):berrySS857b7 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 024786 PRIMARY CONTACT: ❑OWNER El CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:425.776.8835 Tracie Skiles CONTACT EMAIL:tracies@berrysignsystems.com I BUILDING INFORMATION 1 Existing Use of Building: Contract Price of Work: $57955.00 Proposed Use of Building: Heat Source: OGas ❑Electric Other BUILDING USE: DSFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ✓❑Co erciai ❑Accessory Structure Type of Project: ❑New ❑Addition ❑Remodel ❑Repair LIT.I. ❑✓Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: install 4 signs 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/Insert/Log I Roof Drains Water Heater -SPRINKLER/SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other: Water Suppression System Chemical Suppression System I INo.of Heads 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 /,/ #2DOR'' oo 2_ w r/Authorized Agent Signature / Date (Revised 10/10/2018)