4128 RUCKER AVE SAFEWAY 2018-02-23

grr PERMIT APPLICATION BUILDINC 1ECHANICAL / PLUMBING / SIGN •=)RINKLER / 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 1 www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: 4128 Rucker Ave PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) _ CONTACT INFORMATION OWNER NAME: Safeway Inc . TENANT NAME(If Commercial): Safeway OWNER MAILING ADDRESS: STREET CITY STATE ZIP OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: Western States Fire Protection CONTRACTOR ADDRESS: STREET 14690 NE 95th St . #101 CITY Redmond STATE WA ZAP 98252 CONTRACTOR PHONE: 425 . 881 . 0100 CONTRACTOR EMAIL: ryne . fakkema@wsfp . us CONTRACTOR LICENSE#(REQUIRED): WE S TE S F 1 3 6QF CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR ❑ OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 360 . 672 . 5213 Ryne Fakkema CONTACT EMAIL: ryne . fakkema@wsfp . us BUILDING PERMIT APPLICATION Existing Use of Building: Contract Price of Work: $ 1 , 9 0 0 Proposed Use of Building: Heat Source: ❑Gas ❑Electric ❑Other Building Type: USER-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: I_ICommercial ❑Industrial Type of Project: ❑New DAddition ❑Remodel DRepair T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: Add new pendent fire sprinkler heads to accommodate tenant finish wall and ceiling layouts . 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 4 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 I am authorized by the owner of this property to perform the work for which application is made, and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. --7 City of Everett Official Use Only PERMIT# / T May 24 , 2016 ( 7 dw •uthor4z6d Agent Signature Date (Revised 5/20/2016)