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PERMIT APPLICATI� <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 ( FAX 425-257-8857 ((E)everetteps@everettwa.gov� wuvw.everettwa.gov/permits <br /> , �, ,� .. � -, <br /> {Blue or Black,l»k��r�i�r�Ee�se,,. .�....: � . ,�RO;lEGT.SITE INFO. MA�#UN.,>�_,y ,.,,. :; <br /> PROJECT SITE ADDRESS:3900 Broadway PROPERTY TAX#: <br /> LEGAL for new construction: Short Plat/subdivision Lot No. {attach copy of long legal description) <br /> ;=CONTA�T.INFORMA'�'ION: <br /> OWNER NAME: EV@P@tt PUbI1C SChOOIS TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 3900 Broadway <br /> �,n Everett STA-�wA ziP 98203 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME; BG'CY')/SIgC1 $)/SteR1S <br /> CONTRACTOR ADDRESS: STREET 7400 Hardeson Rd <br /> c�rr Everett sra�WA ziP 98203 <br /> CONTRACTOR PHONE: 425.776.8835x114 CONTRACTOR EMAIL: tracies ber si ns stems.com <br /> CONTRACTOR LICENSE#(REQUIRED): be�PySS857b7 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED):O247H6 <br /> PRIMARY CONTACT: ❑OWNER �CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 425.776.8835 X114 <br /> TraCl@ Sk1�2S CONTACT EMAIL:tracies@berrysystems.com <br /> . SUILDING;'P..ERMiT APPL��ATIO�1 ' <br /> Existin Use of Buildin : Contract Price of Work:$6 D00 <br /> Proposed Use of Building: Heat Source: ❑Gas ❑Electric ❑Other <br /> Buildin T e: ❑SFR-Detached ❑SFR-Attached ❑Du lex ❑Multi-Famil -#of Units: ❑Commercial ❑Industrial <br /> T pe of Pro'ect: ❑New �Addition ❑Remodel ❑Re air ❑T.I. QISi n ❑Sprinkier ❑Demolition ❑Chan e of Use <br /> DESCRIPTION OF WORK: <br /> Install 2 lit wall signs and 1 no lit wall sign <br /> ASSOCIATED BUILDING PERMIT# if a licable : <br /> :MECHiANICAL PERMIT,APPLICATION; ` ' ;PL.UMB�NG'�ERMIT.APPLICATION _ <br /> Type of Pro)ect: _New _ Addn Alteration _Repair Type of Project: _New Addn _Alteration _Repair <br /> #of �st of Fixtures #°f List of Fixtures #°f List of Fixtures #of ►Jst of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> A/C—Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) <br /> Forced Air S tems Unit Heater Bathtub Urinal <br /> Gas Piping Boiler Lavatory(Wash Basin) Drinkin Fountain <br /> Water Heater Refri eration 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 /> Ran e Hood Water Heater Other: <br /> Exhaust Fan Sink Service/Bar/Mo /etc. Other: <br /> S�R�N�LfR�1 SUPPRES�I�N SYS,TEM . <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 comp/y with <br /> current federal,state,and local law.The granting of a permit on/y authorizes approved woHc and no deviations therefrom.Deviations must first be authorized in writing from the <br /> Building�cia/before being authorized under any circumstance.I am the owner,or 1 am authorized by the owner of this property to perform the woNc for which application is made, <br /> and I comp/y with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Evereit Official Use Only <br /> PERMIT#�� ��� �� � <br /> V <br /> Owne/A orl ed Agen ature D e (Revised 9/23/2016) <br /> � <br /> � l�� <br />