2615 BROADWAY QFC 2024-02-09 - Laserfiche WebLink

n B•DING PERMIT APPLICATIR CITY OF EVERETT PERMIT SERVICES EVERETT SUBMITTAL INSTRUCTIONS:See applicable submittal checklist for submittal requirements and number of copies required for review, WASHINGTON then drop off completed application plus all required submittal documents to 3200 Cedar Street 2nd Floor Intake Drop Box CONTACT INFORMATION:(P)425-257-8810 I(E)PermitServices@everettwa.gov I(VV)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 2615 BROADWAY PARCEL#: 0003426 ciiv EVERETT STATE WA zip 98201 SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): „ TENANT/BUSINESS NAME(if non-residential):QFC LEGAL DESCRIPTION for new construction' Short Plat/subdivision: Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME:Q F C#50852 OWNER MAILING ADDRESS: STREET 1014 VINE ST clTv CINCINNATI STATE OH Zip 45202 OWNER PHONE:(513)762-4000 OWNER EMAIL: CONTRACTOR COMPANY NAME:Tundra Electri�LC WA STATE CONTRACTOR LICENSE#(REQUUIRED):TUNDREL789D5 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): ,Q S 4 O CONTRACTOR ADDRESS: STREET2311 N. 45th STREET clry SEATTLE STATE WA ZIP 98103 CONTRACTOR PHONE:(206)670-3825 CONTRACTOR EMAIL: PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR Z OTHER(Please Specify) Agent ,CO- NTACT NAME: CONTACT PHONE:(909)455-2588 �� / fi Juan Alonso CONTACT EMAIL:johnny@verxile.com 69gli -`� 116 BUILDING INFORMATION VALUATION OF WORK: $6500 ASSOCIATED LAND USE PROJECT#(if applicable): ▪aluatiof shall include the prevailing fair market value of all labor,materials,and equipment needed to complete the work,whether actually paid or not.) EXISTING USE OF BUILDING:M [PROPOSED USE OF BUILDING: HEAT SOURCE: EGas ❑Electric ❑Other I BUILDING TYPE: ❑SFR EETownhouse ❑Duplex ❑ADU ❑Multi-Family-#Units. ❑✓Commercial ❑Accessory Structure ,TYPE.OF PROJECT(check all that apply): ❑New Construction ❑Addition ❑Remodel ❑Repair i✓JT.I. ❑Change of Use tirlular 111Portable ❑Re roof ❑Exterior Alteration LiTank(above ground) ❑Accessory Structure I 1 ;_ i,:ent::. over 7ft high LIRackStorage ❑Pool/Hot Tub ❑Tank(above ground) ❑Other. DE$.e:RIPTION OF WORK: INSTALL WANZL CLASSIC SWING ACCESS SYSTEM AT ENTRANCE. SYSTEM DESIGNED TO OPEN WITH ONLY 5LBS OF PRESSURE IN CASE OF 1 EMERGENCY. SYSTEM NOT TO ALTER EGREESS PATH OF TRAVEL. SYSTEM ELECTRICAL TO BE FROM NEAREST 20AMP CIRCUIT USING #12 WIRING. 1 i 1 r4CKNr vVLEDGEMENT I nave reviewed this application and confirm the information contained herein is true and correct. Work done pursuant to this permit must comply with :'!.Trent teder*state.and local law. The granting of a permit only authorizes approved work and no deviations therefrom Deviations must first be authonzed in writing from the ._crriduu:Oficirr oefore being authorized under any circumstance.I am the owner.or I am authorized by the owner of this properly to perform the work for which application is made. a)d i comply with the State Contractors Law 18.27 RCW and 296.200A WAC City of Everett Official Use Only l PERMIT# i o` s ,--/ ,� �y,.l.I S / 7—/�— Z7 (/�J ;r• e n d _ent Sign ure Date (Revised 4/21/2022)