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PERMIT APPLICATION <br /> BUILDING / MECHANICAL/ PLUMBING /SIGN /SPRINKLER/ DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> OL 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 l FAX 425-257-8857 1(E)everetteps@everettwa.gov l www.everettwa.gov/permits <br /> (Blue or Black ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: 1122 INDUSTRY ST STE A PROPERTY TAX#: 0250969 <br /> LEGAL for new construction: Short Plat/subdivision Lot No (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: ADVANCED TRAFFIC PRODUCTS TENANT NAME(If Commercial): ADVANCED TRAFFIC PRODUCTS <br /> OWNER MAILING ADDRESS: STREET 1122 INDUSTRY ST STE A <br /> crry EVERETT STATE WA zip 98203 <br /> OWNER PHONE: (425) 347-6208 OWNER EMAIL: EDDIE@ADVANCEDTRAFFIC.COM <br /> CONTRACTOR NAME: NATIONAL SIGN CORPORATION <br /> CONTRACTOR ADDRESS: STREET 1255 WESTLAKE AVE N <br /> ciTv SEATTLE STATE WA zip 98109 <br /> CONTRACTOR PHONE: (206) 282-0700 CONTRACTOR EMAIL: stevez@nationalsigncorp.com <br /> CONTRACTOR LICENSE#(REQUIRED): NATIOSC031 M3 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED):003006 <br /> PRIMARY CONTACT: ❑ OWNER 0 CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: (206) 282-0700 <br /> STEVE ZAMBERLIN CONTACT EMAIL:stevez@nationalsigncorp.com <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: Contract Price of Work: $7,760.00 <br /> Proposed Use of Building: Heat Source: []Gas ❑Electric ❑Other <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ZCommercial ❑Industrial <br /> Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. V]Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: <br /> INSTALL ONE DOUBLE FACE NON ILLUMINATED SIGN DISPLAY AND TWO SINGLE FACE NON ILLUMINATED WALL SIGNS. <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: New _ Addn _Alteration _Repair Type of Project: New _Addn _Alteration _Repair <br /> #of List of Fixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> A/C—Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) <br /> Forced Air Systems Unit Heater Bathtub Urinal <br /> Gas Piping Boiler Lavatory(Wash Basin) Drinking Fountain <br /> Water Heater Refrigeration Shower Floor Drain <br /> Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap <br /> Gas Range Ducting Dishwasher Roof Drains <br /> Clothes Dryer Hookups Other: Clothes Washer Medical Gas <br /> Range Hood Water Heater Other: <br /> Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: <br /> SPRINKLER /SUPPRESSION SYSTEM <br /> Number of Heads <br /> ACKNOWLEDGEMENT 1 have reviewe this application and confirm the information contained herein is true and correct. Work done pursuant to this permit must-.omply with <br /> current federal.state, and local la . Th granting of a permit only authorizes approved work and no deviations therefrom.Deviations must first be authorized in writ ng from the <br /> Building Official before being aut nz under any circumstance l am the owner or l am authorized by the owner of this property to perform the work for which application is made, <br /> and I comply with the Sta Con ct rs Law 18 27 RCW and 296 200A WAC <br /> City of Everett Official Use Onl r <br /> 4/11/2017 <br /> "1 <br /> Owner/Authorized A r <br /> t 4 i I <br /> ature Date (Revised 9/23/2016) <br />