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PERMIT APPLICATIOnI <br /> OLT BUILDIN IECHANICAL / PLUMBING /SIGN-- )RINKLER / DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> ( PROJECT SITE INFORMATION I <br /> PROJECTRSITE ADDRESS: �{[2�D fLe _ / e �. PROPERTY TAX#: <br /> 4128 Rucker Ave Everett,WA.98201 1 O t\ [�1t/► <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Safeway Construction TENANT NAME (If Commercial): Safeway Store#1484 <br /> OWNER MAILING ADDRESS: STREET 1121 124th Ave N.E <br /> CITY Bellevue STATE WA ZIP 98005 <br /> OWNER PHONE: (425)201-6411 OWNER EMAIL: <br /> CONTRACTOR NAME: Tricon Commercial Construction LLC <br /> CONTRACTOR ADDRESS: STREET 385 Old Corvallis Rd <br /> CITY Hamilton �cStArE MT ZIP 59840 <br /> CONTRACTOR PHONE: (406)363-4161 elolv)3dg (`OpXONTRACTOR EMAIL: eds@tc-const.com <br /> CONTRACTOR LICENSE#(REQUIRED): CC TRICOCC881 JO (CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 054243 <br /> PRIMARY CONTACT: ❑OWNER N CONTRACTOR 0 OTHER(Please peeif "-"` ----_-' .-- <br /> CONTACT NAME: CONTACT/HONE: (406)361-0255 <br /> Ed Sharp CONTACT EM :,�s a tc_cottst.com <br /> I BUILDING PERMIT APPLICATION I <br /> Existing Use of Building: Grocery Store Contract Price of Work: $ 35,000 <br /> Proposed Use of Building: Grocery Store Heat Source: ❑Gas DElectric DOther <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex DMulti-Family-#of Units: ®Commercial ❑Industrial <br /> Type of Project: ❑New DAddition ❑Remodel DRepair IT.!. ❑Sign OSprinkler ODemolition ❑Change of Use <br /> DESCRIPTION OF WORK: Add new walls, (2) new strip curtains, concrete curb, new ceiling, tables and shelving. Lower ,�,�o <br /> existing lights and sprinkler-heads. .i /o,s; v5 Pi, - PEEP /R e�TE. ieli a ��'_ 1111 <br /> k.- r" ) to rues l lr <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION 1 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 #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 <br /> Shower Floor DrainGas 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 I <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. 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 WAC. <br /> City of Everett Official Use Only <br /> PERMIT (XI)( 40 14— <br /> Owner/AuTorized Agent Signature Date (Revised 10/12/2015) 1.1-2_ <br />