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4F1T I 1.. 1%HUI I 0-1.1 I 1...1%00-1i I IV I II <br /> BUILDING / MFCHANICAL / PLUMBING / SIGN / S9DINKLER/ DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 982U I <br /> (P)425-257-8810 l FAX 425-257-8857 1 (E)everetteps©everettwa.gov I www.everettwa.gov/permits <br /> Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> 'ROJECT SITE ADDRESS: 4208 Rucker Ave Everett,WA 98203 PROPERTY TAX#: <br /> .EGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> )WNER NAME: Trails End Holding Co., LLC-Chris Amante TENANT NAME(If Commercial): Friendly Foam <br /> )WNER MAILING ADDRESS: STREET PO Box 33456 <br /> CITY Seattle STATE WA ZIP 98133 <br /> )WNER PHONE: 206.353.8473 OWNER EMAIL: chris@friendlyfoam.com <br /> :ONTRACTOR NAME: Advanced Sign and Lighting <br /> :ONTRACTOR ADDRESS: STREET 1 37th St.NW <br /> CITY Auburn STATE WA ZIP 98001 <br /> :ONTRACTOR PHONE: (253) 347-5039 CONTRACTOR EMAIL: asl.taylor.j@gmail.com 11p <br /> :ONTRACTOR LICENSE#(REQUIRED): ADVANSL923DP CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): Oti) <br /> 'RIMARY CONTACT: ❑ OWNER •CONTRACTOR ❑OTHER(Please Specify) <br /> :ONTACT NAME: CONTACT PHONE: 253.243.7777 <br /> Lee Bombacie <br /> CONTACT EMAIL: lee.bombacie@shineonsigns.com <br /> BUILDING PERMIT APPLICATION <br /> ixisting Use of Building: Contract Price of Work: $ $3,500 <br /> 'roposed Use of Building: Heat Source: ❑Gas •Electric ❑Other <br /> Wilding Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: •Commercial ❑Industrial <br /> vype of Project: ❑New DAddition ❑Remodel ❑Repair ❑T.I. ■Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> )ESCRIPTION OF WORK: <br /> Front Lit Illuminated .063 Aluminum Channel Letters with Translucent Vinyl <br /> 1SSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> •ype 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 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 /> • <br /> Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: <br /> SPRINKLER/ SUPPRESSION SYSTEM <br /> Number of Heads <br /> CKNOWLEDGEMENT 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 /> urrent 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 /> wilding 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 /> nd I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> PERMIT# --1 oc <br /> 2.21.2017 <br /> lwner/Authorized Agent Signature Date (Revised 9/23/2016) <br /> t2 <br />