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IP PERMIT APPLICATIOS <br /> #411d// -° ---"A <br /> BUILDING/ MECHANICAL/ PLUMBING/SIGN /SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (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:2110 Hewitt Avenue PROPERTY TAX#:00439168800100 <br /> LEGAL for new construction: Short Plat/subdivision SEC 20 TSP 29 R 5 Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Broadway and Hewitt Investment TENANT BUSINESS NAME(Commercial): TBD <br /> OWNER MAILING ADDRESS: STREET2812 Rucker Avenue <br /> c,n Everett STATE WA ZIP 98201 <br /> OWNER PHONE: (425)760-9336 Howie Bargreen OWNER EMAIL:hbargreen@aol.com <br /> CONTRACTOR NAME:Forest Contracting Inc <br /> CONTRACTOR ADDRESS: STREET27018 233RD Place SE <br /> CITY Maple Valley STATE WA zip 98038 <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL:real@forestcontracting.com <br /> CONTRACTOR LICENSE#(REQUIRED):UBI: 601-034-883 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): ,V 2q0 <br /> PRIMARY CONTACT: E OWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:425-760-9336 <br /> Howie Bargreen CONTACT EMAIL:hbargreen @aol.com <br /> BUILDING INFORMATION <br /> Existing Use of Building:Retail/Trade Contract Price of Work:$$5000__ <br /> TBD ct <br /> Proposed Use of Building: Heat Source: Gas ❑Electric 00ther <br /> BUILDING USE: 7SFR ❑Townhouse ❑Du lex ❑ADU ❑Multi Famil -#Units: ©Commercial ❑AccessorYStructur <br /> e <br /> Type of Project: ❑New ❑Addition ❑Remodel ®'Repair ❑T.I. ❑Sign OSprinkler ®Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: Remove existing failing brick facade above existing froit,entrance to prepare for new construction. <br /> Place temporary contruction fencing in ROW on sidewalk <br /> Ftera:r / /ke/.Icce nos /dtyg Ffa creel e pt ... pIai i . <br /> ASSOCIATED BUILDING PERMIT#(if applicable): PW1606-006 <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 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 Ventilatior 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/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.lam 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 /> Oclf- L1yZOZU PE T ` 1T�LJ'G/ <br /> /�-• '• • S�,PI21,2028 1A) Olt It,G4'v' <br /> Owner/Authorized Agent ' ature Date (Revised w10/10/2018)�, 2 <br /> ww• rorrt6 q 9a►'•4 e y a e... .►� � � � 'J /Z <br /> (9Lr) Lr7 • 5 0 3a �. 'l�U <br />