515 SE EVERETT MALL WAY CHIPOTLE 2017-05-03

PERMIT APPLICATION BUILDING / MECHANICAL / PLUMBING / SIGN / SPRINKLER/ DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 1 FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT SITE ADDRESS:515 SE Everett Mall way PROPERTY TAX#: 28051 800304800 LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: Greentree Plaza 06A LLC TENANT NAME(If Commercial): Chl otle OWNER MAILING ADDRESS: STREET 12411 Ventura Blvd CITY Studio City STATE CA ZIP 91604 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: TubeArt CONTRACTOR ADDRESS: STREET 11715 SE 5th ST CITY Bellevue STATE WA ZIP 98005 CONTRACTOR PHONE: 206 264 2954 CONTRACTOR EMAIL: Shawnb tubeart.com CONTRACTOR LICENSE#(REQUIRED): TUBEAD*311 QS ICITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 006667 PRIMARY CONTACT: ❑OWNER CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 206 264 2954 Shawn Bowen CONTACT EMAIL: Shawnb@tubeart.com BUILDING PERMIT APPLICATION Existing Use of Building: Contract Price of Work:$ 6000.00 Proposed Use of Building: Heat Source: []Gas ❑Electric ❑Other Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.l. I Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: Install 2 wall signs 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 List of Fixtures #of List of Fixtures #of List of Fixtures #of 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 Number of Heads 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 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 any circumstance. I am the owner,or/am authorized by the owner of this property to perform the work for which application is made, and 1 comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only Owner/Auth Ag nt ignature Date (Revised 10/12/2015) 22 . Cod ��