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PERMIT APPLICATIOh <br /> BUILDING / MECHANICAL/ PLUMBING / SIGN / SPRINKLER/ DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 1 FAX 425-257-8857 1 (E)everetteps@evereftwa.gov I www.evereftwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: 1515 132nd St E, Everett WA 98012 1 <br /> PROPERTY TAX#: 28053000406500 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Mccorthy/Afifi/Boswell Mill Creek LLC TENANT NAME(If Commercial): Murphy Corner Mobil <br /> OWNER MAILING ADDRESS: STREET 406 Boston Street <br /> CATV Seattle STATE 111IA z, 98208 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: Insignia Sign Inc. <br /> CONTRACTOR ADDRESS: STREET PO BOX 2849 <br /> ciTv Renton STATE WA z, 98056 <br /> CONTRACTOR PHONE: (425)917-2109 CONTRACTOR EMAIL: steven@inslgnlaslgn.com <br /> CONTRACTOR LICENSE#(REQUIRED): INSIGSI062QZ ICITY OF EVERETT BUSINESS LICENSE#(REQUIRED): <br /> PRIMARY CONTACT: ❑OWNER Ill CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: (425)917-2109 <br /> Steven Thomson I@ Insignia Sign Inc. CONTACT EMAIL: steven@insigniasign.com <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: 76 Gas Station Contract Price of Work:$20,000.00 <br /> Proposed Use of Building: Mobil Gas Station Heat Source: ❑Gas ❑Electric ❑Other <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: Wommercial ❑Industrial <br /> Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.l. INSign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: <br /> RM Replace existing 76 monument faces with new Mobil monument faces:J9,,/EF4ffVN1Y-N0 ST.?YUY9A1 CNANVESTOMISTINGNONYRRY'SISNJ <br /> ®&® Install 2 new 2"x6'-10" LED illuminated Mobil wall signs(1 on East canopy elevation &1 on West canopy elevation): <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 It 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/IvMopfete.) Other: <br /> SPRINKLER/ SUPPRESSION SYSTEM <br /> Number of Heads b, <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.I 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 WAG. <br /> City of Everett Oficial Use Only <br /> PERMIT# <br /> 9&ve*t `71to 4o*t (Contractor &Agent) 01/21/16 <br /> Owner/Authorized Agent Signature Date (Revised 10/1212015) r <br /> 1/ <br />