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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 � FAX 425-257-8857 �(E)everetteps@everettwa.gov� www.everettwa.gov/permits
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<br /> PROJECT SITE ADDRESS: ��'��E ����Q �� �� �E PROPERTY TAX#:�'$ 2 b��"IC�O Jv���}
<br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description)
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<br /> OWNER NAME: Ezell Stephens TENANT NAME(If Commercial)• eaven Sent Fried Chicken
<br /> OWNER MAILING ADDRESS: srReer 615 112th St SE �—
<br /> cirr Everett STATE WA zia 98208
<br /> OWNER PHONE: 206-353-6858 OWNER EMAIL:
<br /> CONTRACTOR NAME: Rainier Industries
<br /> CONTRACTOR ADDRESS: srneer 18375 Olympic Ave S
<br /> cirr Tukwila srAre WA ZiP 98188
<br /> CONTRACTOR PHONE: 425-981-1214 CONTRACTOR EMAIL: lukew@rainier.com
<br /> CONTRACTOR LICENSE#(REQUIRED): �INIIL066QP CITY OF EVERETT BUSINESS LICENSE#(REQUIRE ): 023736
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<br /> PRIMARY CONTACT: ❑OWNER �CONTRACTOR 0 OTHER(Please Specify)
<br /> CONTACT NAME: Luke Walker CONTACT PHONE: 425-981-1214
<br /> CONTACT EMAIL: lukew@rainier.com
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<br /> Existing Use of Building: Contract Price of Work:$7 679.00
<br /> Proposed Use of Buildin : Heat Source: ❑Gas ❑Electric ❑Other
<br /> Buildin T pe: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Famii -#of Units: �Commercial ❑Industrial
<br /> T pe of Pro'ect: ❑Ne �Addition ❑Remodel ❑Repair ❑T.I. ❑Si n ❑Sprinkier ❑Demolition ❑Change of Use
<br /> DESCRIPTION OF W 4ea wedge awning fabric recovers:
<br /> 2-17'(w)x 4'(h)x 3'(d), 1 -17'-4"(w)x 4'(h)x 3'(d), 1 -19'(w)x 4'(h)x 3'(d),all with 12"truss
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<br /> ASSOCIATED BUILDING PERMIT# if a licable:
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<br /> Type of Project: New Addn _Alteration Repair Type of Project: New Addn _Alteration Repair
<br /> #of List of Fixfures #of List of Fixfures #of List of Fixtures #of List of Fixtures
<br /> Fixtures Fixfures Fixiures Fixtures
<br /> A/C-Air Handlin Units Heat Pump Toilet Backflow Preventer(Inside Bld )
<br /> Forced Air Systems Unit Heater Bathtub Urinal
<br /> Gas Pipin 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 D er Hookups Other. Clothes Washer Medical Gas
<br /> Range Hood Water Heater Other:
<br /> Exhaust Fan Sink Service/Bar/Mop/etc. Other:
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<br /> Chemical or Water No.of Heads
<br /> ACKNOWLEDGEMENT.•1 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 O�cial before being authorized under any circumstance.1 am the owner,or I am authorized by the owner of this property to perform the work for which application is made,
<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 /> PERMIT#
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<br /> Owner/Authorized Agent Signature Date (Revised 9/23/2 16)
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