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PERMIT APPLICATI�� <br /> BUILDIN�I■I..�VIECHANICAL/ PLUMBING /SIG��bRINKLER/ 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� www.everettwa.gov/permits <br /> (Biue or Black lnk Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS:2O9 E. CaSlllO ROaC�, Ste A PROPERTY TAX#: OZ�H7Z7 <br /> LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: CaS1110 SqUaC@ EaSt TENANT NAME(If Commercial): Ma�/a S@I'VIC@S <br /> OWNER MAILING ADDRESS: srReeT 10655 NE 4th Street <br /> �,n Bellevue STATE WA Z�P 98004 <br /> OWNER PHONE: 425-276-7391 OWNER EMAIL: <br /> CONTRACTOR NAME; TIl2 Slgll POSt, Inc. <br /> CONTRACTOR ADDRESS: s-rReeT 2O�9 E. BalCel"VIeW ROaC� <br /> cm� Bellin ham STATEWA ziP98226 <br /> CONTRACTOR PHONE: 360-67�-�343 CONTRACTOR EMAIL: IOI"@fl@ the-si Il OSt.CO�"Yl <br /> CONTRACTOR LICENSE#(REQUIRED): SIGNPI*065MM CITY OF EVERETI'BUSINESS LICENSE#(REQUIR ): <br /> PRIMARY CONTACT: ❑OWNER TC7 CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 36�-67�-�3L�,3 <br /> GIOr@rl@ G@Oi"g@ CONTACT EMAIL: IOI"2t12 th@-SI npost.C0111 <br /> _ _ _ _ _ _ ____ <br /> ' BUILDING PERMIT APPLICATION °' ' <br /> Existing Use of Building: R@tall Contract Price of Work:$4,8��.�� <br /> Proposed Use of Building:Retall Heat Source: ❑Gas ❑Electric ❑Other <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: rC7Commercial ❑Industrial <br /> Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. OSign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: <br /> storefront and side wall si n installed <br /> g <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION G PLUMBING PERMIT APPLICATION <br /> Type of Project: _New Addn _Alteration _Repair Type of Project: _New _Addn _Alteration _Repair <br /> #of List of Fixtures #�f List of Fixtures #of List of Fixtures #of List of Fixtures <br /> Fixtures Pixfures 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:/have reviewed this application and confirm the information contained herein is true and correcf. 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 1 am authorized by the owner of this property to perform the work for which application is m de, <br /> and 1 comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett O�cial Use Only <br /> GLORENE GEORGE 01/05/17 PERMI <br /> ��'0� -C� � �, <br /> Owner/Authorized Agent Signature Date (Revised 9/23/2016) <br />