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PERMIT APPLICATIO�� <br /> BUILDING ECHANICAL / PLiUMBING / SIGN 'RINKLER / DEMOLITION <br /> CITY OF EVEF2ETT PERMIT SERVICES <br /> 3200 CEDAR STI�EET, EVERETT,WA 98201 <br /> (P)425-257-8810 � FAX 425-257-8857 � (E)everetteps@everettwa.gov� www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: 1525 75th Street 5W, Everett, WA 98201 PROPERTY TAX#: 28041 1 001 00500 <br /> LEGAL for new construction: Short PlaUsubdivision _Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: JOHNSON PROPERTIES I LLC TENANT NAME(If Commercial): Comcast <br /> OWNER MAILING ADDRESS: srREET P O BOX 5253 <br /> CITY EVERGTT STATE WA ZIP 9II206 <br /> OWNER PHONE: (425)606-7215 OWNER EMAIL: JOELLE LABLOND@cable.comcast.com <br /> CONTRACTOR NAME: NWSigta� � — 1 � <br /> CONTRACTOR ADDRESS: sTREET nzov eeaco�Ra.sE <br /> CITY Monroe STATE WA ZIP 982/2 <br /> .— •� <br /> CONTRACTOR PHONE: 425-844-6415 CONTRACTOR EMAIL: Jerry@NWSigns.com ��� <br /> CONTRACTOR LICENSE#(REQUIRED): NV�M/HOS"929M9 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED: 053987 <br /> PRIMARY CONTACT: ❑ OWNER � CONTRACTOR ❑ OTHER (Ple�ase Specify) <br /> CONTACT NAME: Jerry Austin CONTACT PHONE: 425-844-6415 <br /> CONTACT EMAIL: �erry@NWSigns.com <br /> BUILDING PERMI'T APPLICATION <br /> Existing Use of Building: Offices Cc�ntract Price of Work• 15,691.79 <br /> Proposed Use of Building: He:at Source: ❑Gas ❑Elec ❑Other <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: �Commercial ❑Industrial <br /> Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. IX-1Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: Remove and replace old monument with new monument. Non-illuminated sign cabinet with base and <br /> new footing. Replace tenant panel on tenant directory sign. <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New _ Addn _Alteration _Repair Type of Project: _New _Addn _Alteration _Repair <br /> #of Lisi of Fixtures #of List of Fixtures #�f List of Fixtures #°f List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> A/C—Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bidg) <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 /> Chemical or Water No. of Heads <br /> ACKNOWLEDGEMENT:I have reviewed this application and confirm the information conta!ned 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 1 comply wi the State on actors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> PERM T <br /> - S ( � ( ��� --Oa <br /> O ner/Auth ized A Signature Dat (Revised 9/23/2016) <br />