12906 19TH AVE SE JOINT CHIROPRACTIC 2023-07-31

NINO PERMIT APPLICATION"' BUILDIN MECHANICAL/ PLUMBING / SIGNPRINKLER/ 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 l www.everettwa.gov/permits (Blue or Black Ink Only Please)y PROJECT SITE INFORMATION PROJECT SITE ADDRESS:12906 Bothei4-Everett Wm-y, Suite C Everett, WA 98208 PROPERTY TAX#:28053000406200 LEGAL for new construction: Sho' Plat/subdivision Lot No. (attach copy of long legal description) t CONTACT INFORMATION OWNER NAME: Fred Meyer S •res Inc TENANT BUSINESS NAME(Commercial): The Joint Chiropractic OWNER MAILING ADDRESS: STREET 014 VINE ST FL CITY Cin..natti STATE OH ZIP 45202 OWNER PHONE: 503-539-8156 OWNER EMAIL:SISbell@l045inc.com CONTRACTOR NAME:Berry Sign CONTRACTOR ADDRESS: STREET5002 S W. hington St ciTY Tacoma STATE WA ZIP 98409 CONTRACTOR PHONE:253 830-3600 CONTRACTOR EMAIL:mikeI G@berr/sign.com CONTRACTOR LICENSE#(REQUIRED):Berryss857b7 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 024786 PRIMARY CONTACT: ❑OWNER El CONTRACTOR 0 OTH (Please Specify) CONTACT NAME: CONT• T PHONE:253 830-3600 Mike Lee CONTAC EMAIL:mikel rnikel@berrysign.com BUILDING INF• •MATION Existing Use of Building:COmmercial Contract'rice of Work:$10000 Proposed Use of Building: Heat Sour ❑Gas 0Electric ❑Other BUILDING USE: OSFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Uni•.: Commercial Accessory Structure Type of Project: New Addition Remodel ❑Repair ❑T.I. ❑✓Sign • •.rinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: Install one illuminated wall sign ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING 'ERMIT 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 'aste/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 eater SPRINKLER/ SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other: SIGNS 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 perm.),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 PERMIT# /%%/ 7.28.2022 T O V i Owner/Authorized Agent Signature Date (Revised 10/10/2018) l ./z