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BUILDINIa / MECHANICALE PL'U BPING CSIG� �PRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 � FAX 425-257-885Z �(E)everetteps@everettwa.gov� wuvw.everettwa.gov/permits <br /> _ � _ . � <br /> �Bl��.ar Blacl��nk Oni .P1 asej � _ �; PROJE�T S�TE INFaRMATION � ` <br /> ...�., .. 1�, ,." . , "�' . ,., �.."�.�..,:, ��.*,� „h. <br /> PROJECT SITE ADDRESS:7601 Evergreen Way PROPERTY TAX#: <br /> LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br /> _ ,:.. „, ,,s _� . ,,. . � �.� ' �<: -.;�, � <br /> ,. . <br /> :. C.ONT`ACT INF.ORMATION':: <br /> OWNER NAME: SafeWay TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: sraee-r 7601 Evergreen WAy <br /> �,TM Everett STATE WA ziP 98203 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME; Berry Sign Systems <br /> CONTRACTOR ADDRESS: STREET 7400 Hardeson Rd <br /> cnY Everett STA7E WA ziP 98203 <br /> CONTRACTOR PHONE: 425.776.8835x114 CONTRACTOR EMAIL: tracies ber si ns stems.com <br /> CONTRACTOR LICENSE#(REc1UIRED): b@CI'ySS857b7 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED):O24TH6 <br /> PRIMARY CONTACT: ❑OWNER jZl CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 425.776.8835 X114 <br /> Traeie Skiles CONTACT EMAIL:tracies@berrysystems.com <br /> �._ BUILDING;PERMIT APRL1C14TION ': <br /> Existin Use of Buildin : Contract Price of Work:$ ' c � o <br /> Proposed Use of Building: Heat Source: ❑Gas ❑Electric ❑Other <br /> Buildin T pe: ❑SFR-Detached ❑SFR-Attached ❑Du lex ❑Muiti-Famil -#of Units: ❑Commerciai ❑industrial <br /> T pe of Pro'ect: ❑New �Addition ❑Remodel ❑Repair �T.I. {Z1Si n ❑Sprinkler ❑Demolition ❑Chan e of Use <br /> DESCRIPTION OF WORK: <br /> install 4wall signs on gas station <br /> ASSOCIATED BUILDING PERMIT# if a licable : <br /> , .. ,z.. � . _ .,. <br /> MECNANICAL,PERMiT APPLI.CATION::' ; ; PLUMBING:PERMI,T APPLICATIOI� ' , ', " „ <br /> Type of Project: _New Addn _Alteration _Repalr Type of ProJect: New Addn _Alteration _Repair <br /> #of List of Fixtures #of List of Fixtures #°f List of Fixtures #°f List of F/xtures <br /> Fixtures Fixtures Fixtures Flxfures <br /> A/C—Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) <br /> Forced Air S stems Unit Heater Bathtub Urinal <br /> Gas Piping Boiler Lavatory Wash Basin) Drinking 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 /> Range Hood Water Heater Other: <br /> Exhaust Fan Sink Service/Bar/Mop/etc. Other: <br /> SPR1N1(I,ER I.SUPPRESSI,ON,SYS'�EM,:; „M:; <br /> Number of Heads <br /> ACKNOWLEDGEMENT:/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/ocal law.The granting of a permit on/y authorizes approved work and no deviations therefrom.Deviations must first be authorized in writing from the <br /> Building O�cia/before being authorized under any circumstance.I am the owner,or I am authorized 6y the owner of this property to perform the work for which application is made, <br /> and/co p/y with the Sfate Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett O�cia/Use On/y <br /> ` j � PERMIT#f1, ���� �� <br /> � �„...,;__ <br /> Owne A or Agent Signature Date (Revised 9/23/2016) � <br /> ��� <br />