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4rETT PERMIT APPLICATION - <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 I FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: PROPERTY TAX#:01 4 6 4 15 <br /> 11031 19th Ave SE Everett,WA 98208 <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#0503 <br /> OWNER MAILING ADDRESS: STREET 1121 124th Ave N.E <br /> crry Bellevue STATE WA ZIP 98005 <br /> OWNER PHONE: (425) 201-6411 OWNER EMAIL: <br /> CONTRACTOR NAME Tricon Commercial Construction <br /> CONTRACTOR ADDRESS: STREET 385 Old Corvallis Rd <br /> CITY Hamilton STATE MT ZIP 59840 <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> CONTRACTOR LICENSE#(REQUIRED): 603-194-606 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 054243 <br /> PRIMARY CONTACT: 0 OWNER I,lt CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: Ed Sharp CONTACT PHONE: (406)361-0255 <br /> (,6- -3(c-- X 77 ( <br /> CONTACT EMAIL: eds©tc-const.com,4�"Q j keJiG•6�),7t�r6c)/� <br /> BUILDING PERMIT APPLICATION / /Z0 q bA1 <br /> Existing Use of Building: Grocery Store Contract Price of Work: $ $35,000 1 <br /> Proposed Use of Building: Grocery Store Heat Source: ❑Gas ❑Electric DOther <br /> Building Type: DSFR-Detached DSFR-Attached ❑Duplex DMulti-Family-#of Units: Commercial ❑Industrial <br /> �C <br /> Type of Project: ❑New DAddition DRemodel DRepair i T.l. ❑Sign ❑Sprinkler DDemolition ❑Change of Use <br /> DESCRIPTION OF WORK: Add new walls and strip curtain, add new ceiling, lower existing lights and sprinkler heads to new <br /> ceiling height, add new shelving and tables. <br /> ASSOCIATED BUILDING PERMIT#(if applicable): ! iN i ( (h (AMtxo) vi/ I, <br /> N� t <br /> MECHANICAL PERMIT APPLICATION PLUMBING PE MIT 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 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/Mop/etc.) Other: <br /> SPRINKLER/SUPPRESSION SYSTEM <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 <br /> Owner/Authorized A.• t Signature D.e (Revised 10/12/2015) <br />