10200 19TH AVE SE COSTCO FOOD COURT 2017-03-13

. I 41ETT1 el PERMIT APPLICATION BUILDING / MECHANICAL / PLUMBING / SIGN / SPRINKLER/ DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 I (E)everetteps@everettwa.gov I www.everettwa.govipermits PROJECT SITE INFORMATION PROJECT SITE ADDRESS: PROPERTY TAX#: p j 2 U-e S G 2 7 'l LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: COS)- CO (t) /2 (off. TENANT NAME(If Commercial): OWNER MAILING ADDRESS: l9 STREET /67 kne.. 1)r� /, .� ✓e1� CITY (tet/ STATE C/KV Z? ZIP OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: 4 4/4 fit`(/e CONTRACTOR ADDRESS: 3013 STREET 3 1 LR CITY 5 -7 /- STATE 9 ZIP q N0 CONTRACTOR PHONE: 70(p- 7 Z / CONTRACTOR EMAIL: .a Y,q"' i a 4'Ir v'e . c ort CONTRACTOR LICENSE#(REQUIRED): 4i. A F,-.5 I 1`(UDS CITY OF EVERETT BUSINESS LICENSE#(REQUIRED):0 27-(ow/- PRIMARY CONTACT: ❑ OWNER jaCONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: Z S 3 ' Z02- 7 /X 2.- 7k7k y (-) 5c h i q /✓ CONTACT EMAIL: fZ S/A r+CcJ c14 G, F; BUILDING PERMIT APPLICATION _ Existing Use of Building: Contract Price of Work: $ '3 K 3Z . 0 0 Proposed Use of Building: Heat Source: ❑Gas ❑Electric ❑Other _ Building Type: DSFR-Detached DSFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial _ Type of Project: New ❑Addition ❑Remodel ❑Repair IET.I. DSign DSprinkler ❑Demolition ❑Change of Use _ DESCRIPTION OF WORK: ZN “"6.// -/-(/or Ft ✓�e Svl2% -ess,'0,) Sy S.P>M ASSOCIATED BUILDING PERMIT#(if applicable): _ MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Type of Project: New Addn Alteration Repair Type of Project: New Addn Alteration Repair #of #of List of Fixtures #of List of Fixtures #of List of Fixtures List of Fixtures Fixtures Fixtures Fixtures Fixtures A/C-Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) _Forced Air Systems _ Unit Heater Bathtub Urinal _ Gas Piping _ Boiler Lavatory(Wash Basin) Drinking Fountain Water Heater Refrigeration Shower Floor Drain Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap Gas Range Ducting Dishwasher Roof Drains Clothes Dryer Hookups Other: Clothes Washer Medical Gas _ Range Hood Water Heater Other: Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: SPRINKLER/ SUPPRESSION SYSTEM we),, CIt[M 31_0-en Number of Heads ACKNOWLEDGEMENT:1 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 an ircumstance.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 _• . ors . • 0:. 7 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT# \u/rol___ Owner/Authorized A.ent Signature Date (Revised 10/1 /2015)