12906 19TH AVE SE 2023-04-07 - Laserfiche WebLink

PERMIT APPLICATION. BUILDING / MECHANICAL I 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:1290619th Ave SE, Everett, WA 98208 PROPERTY TAX#:28053000406200 LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) • CONTACT INFORMATION OWNER NAME: Fred Meyer Stores - Russell Vickroy TENANT BUSINESS NAME(Commercial): Fred Meyer OWNER MAILING ADDRESS: STREET1014 Vine St. Fl 7 cm, Cincinnati STATE OH ZIP 45202 OWNER PHONE: 503.797.3921 OWNER EMAIL:russell.vickroy@fredmeyer.com CONTRACTOR NAME: Engineered Structures, Inc. - Matt Kirtley CONTRACTOR ADDRESS: STREET 3330 E. Louise Drive, Ste. 300 CITY Meridian STATE ID ZIP 83642 CONTRACTOR PHONE: 208.362.3040 CONTRACTOR EMAIL: _ _ rTlattkirtley©esiCOnstruCtiOn.COm CONTRACTOR LICENSE#(REQUIRED): ENGINSI152K2 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED):48496 PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR i]OTHER(Please Specify) Applicant CONTACT NAME: CONTACT PHONE:360,953.8517 Pam Deegan CONTACT EMAIL:pam@westernconstruction.com BUILDING INFORMATION Existing Use of Building:M Contract Price of Work:$195,000 Proposed Use of Building:M (No Change) Heat Source: I Gas ❑Electric ❑Other BUILDING USE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: (]Commercial ❑Accessory Structure Type of Project: ❑New ❑Addition ORemodel ❑Repair ❑T.I. ESign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: Fixture replacement in the Photo Electronics and Music Department(PEM).An new glass window wall will be built. New checkout counters will be installed. 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 Ventilatior Floor Drain Toilet Exhaust Hood(Type I) (Not HeaUAC 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 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 PAR T ✓ Owner/Auth d 10.02.20 #�-'��)Agent Signature V Date (Revised 10/10/2018) IZ_