11020 19TH AVE SE BARTELL DRUGS 2018-02-27

PERMIT APPLICATION BUILDING / MECHANICAL/ PLUMBING / SIGN / SPrcINKLER/ DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 (E)everetteps@everettwa.gov I www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: 11020 19th Ave SE PROPERTY TAX#: 28051900400500 LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: Coastal Serhoe TENANT NAME(If Commercial): Bartell's OWNER MAILING ADDRESS: STREET PO BOX 1393 CITY YAKIMA STATE WA ZIP 98907 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: State Mechanical CONTRACTOR ADDRESS: STREET 8706 S 222nd St cry Kent STATE WA ZIP 98031 CONTRACTOR PHONE:206-575-7527 CONTRACTOR EMAIL: stevec@statemech.net CONTRACTOR LICENSE#(REQUIRED): STATEMC141C7 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 030329 PRIMARY CONTACT: ❑OWNER ®CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: Steve Carney CONTACT PHONE: 206-575-7527 CONTACT EMAIL:stevec@statemech.net BUILDING PERMIT APPLICATION Existing Use of Building: Contract Price of Work:$1,800.00 Proposed Use of Building: Heat Source: ❑Gas DElectric ❑Other Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ®Commercial ❑Industrial Type of Project: ❑New EAddition ❑Remodel CI Repair ®T.l. ESign ❑Sprinkler ❑Demolition EChange of Use DESCRIPTION OF WORK: To plumb and install: 1 Sink c9-o2 _oL2 ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION ' PLUMBING PERMIT APPLICATION Type of Project: _New _ Addn Alteration Repair Type of Project: _New _Addn X Alteration Repair #of List of Fixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures Fixtures Fixtures Fixtures Fixtures A/C-Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) Forced Air Systems Unit Heater Bathtub Urinal Gas Piping Boiler Lavatory(Wash Basin) Drinking Fountain Water Heater Refrigeration Shower Floor Drain Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap Gas Range Ducting Dishwasher Roof Drains Clothes Dryer Hookups Other: Clothes Washer Medical Gas Range Hood Water Heater Other: Exhaust Fan 1 Sink(Service/Bar/Mop/etc.) Other: SPRINKLER/SUPPRESSION SYSTEM Chemical or Water No. of Heads ACKNOWLEDGEMENT:I have reviewed this application and confirm the information contained herein is true and correct. Work done pursuant to this permit must comply with current federal,state,and local law The granting of a permit only authorizes approved work and no deviations therefrom.Deviations must first be authorized in writing from the Building Official before being authorized under any circumstance. I am the owner,or/am authorized by the owner of this property to perform the work for which application is made, and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only qq�.��--,,�� PEf$V�11� -.2AW" 3/9/37 (4n3 C -- Owner/Authorized Agent Signature Date (Revised 9/23/2016)