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PERMIT APPLICATIO _ <br /> BUILDIN(ECHANICAL / PLUMBING / SIGN RI <br /> CITY OF EVERETT PERMIT SERVICLS D <br /> 3200 CEDAR STREET, EVERETT,WA 98201 �y <br /> (P)425-257-8810 FAX 425-257-8857 1 (E)everetteps@everettwa.gov I veret o�¢/p1rn@416 <br /> PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS:2801 Hewitt Ave PROPERTY TAX#:0059366560100 l WORKS <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT,INFORMATION <br /> OWNER NAME: Eckstrom Thomas S and ihTENANT NAME(If Commercial): Emerald City Solutions <br /> OWNER MAILING ADDRESS: STREET PO Box 1386 <br /> airy Everett STATE WA zip 98206 <br /> OWNER PHONE:(425) 609-1911 OWNER EMAIL:teckstrom@beitconSUlting.com <br /> CONTRACTOR NAME:Paclfic Sign Erectors <br /> CONTRACTOR ADDRESS. STREET 9792 Edmonds Way Suite 172 <br /> CITY Edmonds STATE WA zip 98020 <br /> CONTRACTOR PHONE:206-427-2278 CONTRACTOR EMAIL:pacificsignerectors@msn.Com <br /> CONTRACTOR LICENSE#(REQUIRED):PACIFSE965CK ICITY OF EVERETT BUSINESS LICENSE#(REQUIRED): <br /> PRIMARY CONTACT: ❑ OWNER ONTRACTOR ✓ THER(Please Specify) Subcontractor Metrosign <br /> CONTACT NAME: CONTACT PHONE:206-427-2278 <br /> Jamie Zaretsky CONTACTEMAIL:jamie@metrosignseattle.com <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building:Special Construction Trade Contract Price of Work: $4000 <br /> Proposed Use of Building: Heat Source: ❑Gas ❑Electric ❑Other <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Mu mily-#of Units: ❑Commercial ❑Industrial <br /> Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. 1 V� 6n ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: <br /> manufacture and install (1) new double faced illuminated projecting <br /> sign <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 #of <br /> List of Fixtures 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:I have reviewed this application and confirm the information contained herein is true and correct. Work done pursuant to this permit must comply with <br /> 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 <br /> Building Official before being authorized under any circumstance.t am the owner, or I am authorized by the owner of this property to perform the work for which application is made, <br /> and I comply with the State Contractors Law 18 27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> Owner/Auth ized Agent Signature Date (Revised 10/12/2015) <br />