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PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET. EVERETT. WA 98201 <br />425-257-8810 - FAX 425-257 8857 - www.evereftwa.org <br />APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM <br />SITE ADDRESS <br />PARCEL TAX I.D. # <br />I PrR T # <br />12906 19th Avenue SE (Bothell -Everett Highway) <br />280530-004-062-00 <br />JJ <br />LEGAL LOT NO. <br />BLOCK <br />TRACT OR SUBDIVISION # <br />DESC. <br />See Attached Legal Description <br />OWNER ADDRESS CITY/ZIP PHONE <br />Fred Meyer Stores, Inc 3800 SE 22nd Avenue James Coombes 503-797-5617 (P) <br />Division of The Kroger Company Portland OR 97202 Senior Entitlements Manager 503-797.3539 IF) <br />TENANT NAME <br />CONTACT FOR PERMIT PHONE 425-656-1061 <br />Robert McNeill, Senior Planner <br />I <br />Barghausen Consulting Engineers, Inc E-MAILbmcneill@barghausemcom <br />CONTRACTADDRESS YIZ PPPHONE <br />+' <br />�`-��y'�� �'h UL /-O�t'Lf- <br />CONTR. LICENSE # TBD <br />em s, NO r ice -7 7 <br />USE OF BUILDING <br />HEAT SOURCE <br />CONTRACT PRICE OF WORK <br />Fred Meyer Fuel Facility <br />( <br />— Electric Gas Other <br />TBD <br />WORK DESCRIPTION <br />Construct a retail fueling facility with a 24- by 144-fool fuel canopy (3,456 square feel), with a cashier's kiosk and five (5) <br />multi -product dispensers (MPDs). The project also calls for the installation of two (2) underground storage tanks (USTs). <br />one 20,000-gallon tank for regular unleaded fuel and one 18,000-gallon split/dual tank (10,000/8,000) for diesel and <br />supreme unleaded fuel. Additional improvements include asphalt paving, lot lights, signage and utility connections. <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITF1.1 <br />NO. TY.^F OF FIXTURE OR ITEM <br />Toilet Kios:t eyes store reslrooms <br />A/C - air handling units HVAC unit (kiosk) <br />Bathtub <br />Forced air systems <br />_ <br />_ <br />Lavatory (wash basin) <br />Gas piping <br />Shower <br />Water healer <br />_ <br />Kitchen sink & disposal <br />Gas fireplace <br />Dishwasher <br />Gas range <br />_ <br />Clothes washer <br />Clothes dryer <br />Water heater <br />Range hood <br />_ <br />Sink (service/bar/mop/etc.) <br />_ <br />Exhaust fan <br />_ <br />Backflow preventer <br />Heat pump <br />Urinal <br />_ <br />Unit heater <br />_ <br />_ <br />Drinking Fountain <br />Boiler <br />_ <br />Floor drain <br />Refrigeration <br />_ <br />Grease trap <br />Woodstove <br />_ <br />Roof drains <br />Other _ <br />Other <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby ceritily that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br />ordinates governing this type of work will be complied with whether specified herein or net. The granting of a permit does not presume <br />to give authority to violate or cancel the provision of any other state or local law regulating construction or the performance of <br />construction. That I am authorized by the owner of this property to perform the work for which application is made and I comply with the <br />Sta:C`ontractbrs Law 18.27 RCW and 296.200 WAC. <br />Signatu a of Owner/Contractor/Authorized Agent Date <br />Robert McNeill, Senior Planner <br />Barghausen Consulting Engineers, Inc. 18215 72nd Avenue S, Kent WA 98032 ,// <br />