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PERMIT APPLICATIO• <br /> BUILDING/MECHANICAL/PLUMBING/SIGN /SPRINKLER/DEMOLITION <br /> ��VJ�'� CITY OF EVERETT PERMIT SERVICES <br /> ' ' 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 1 FAX 425-257-8857 1(E)everetteps@everettwa.gov 1 www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION, <br /> PROJECT SITE ADDRESS: 4128 Rucker Ave. PROPERTY TAX it: 005821 01 401 700 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of tong legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Safeway, Inc TENANT NAME(If Commercial): Starbucks <br /> OWNER MAILING ADDRESS: STREET 1371 Orchard Blvd., #200 <br /> cm Walnut Creek STATE CA ZIP 94596 <br /> OWNER PHONE: 425 201-6411 OWNER EMAIL: joe.janus@safeway.com <br /> CONTRACTOR NAME: Tricon Commercial Construction <br /> CONTRACTOR ADDRESS: siieEr 385 Old Corvalis Road <br /> cnv Hamilton STATE MT ZAP 59 0 <br /> CONTRACTOR PHONE: 406 381-3785 CONTRACTOR EMAIL: billr@tc-const.com <br /> CONTRACTOR LICENSE#(REQUIRED): TRICOCC881 JO CITY OF EVERETT BUSINESS LICENSE#(REQUI ): 054243 <br /> PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR RI OTHER(Please Specify) Architect <br /> CONTACT NAME: Brian Elliott CONTACT PHONE: 206 519-5145 <br /> CONTACT EMAIL: brian.elliott@graphitedesigngroup. m <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: Retail (M) Contract Price of Work:$ $30.000 <br /> Proposed Use of Building: Retail (M) Heat Source: OGas ❑Electric ❑Other <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ISICommercial ❑Industrial <br /> Type of Project: ❑New ❑Addition I2Remodel ❑Repair ❑T.1. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: <br /> Re-clad and expansion of existing stand-alone interior sales kiosk; New equipment and casework along with re-installation of <br /> some existing equipment and casework;• ,'•'••- - - - '••�e• • •• •• - •e - - - .- -- -=•' <br /> ASSOCIATED BUILDING PERMIT#(if applicable): U .� <br /> MECHANICAL PERMIT APPLICATION`- PLUMBING PERMIT APPLICATION <br /> Type of Project: _New _ Addn _Alteration _Repair Type of Project: _New Addn ,I.Alteratlon _Repair <br /> #of #°f List of Fixtures List of Fixtures # ' List of Fixtures #°f List of Fixtures <br /> Fixtures Fixtures Fixtu Fixtures <br /> A/C—Air Handling Units Heat Pump •filet ackflow Preventer(Inside Bldg) <br /> Forced Air Systems Unit Heater Ba ub Urinal <br /> Gas Piping Boiler Lavato ash Basin) Drinking Fountain <br /> Water Heater Refrigeration Shower 2 Floor Drain <br /> Gas Fireplace Wood Stove Kitchen Sink& I •, al 1 Grease Trap <br /> Gas Range Ducting Dishwasher Roof Drains <br /> Clothes Dryer Hookups Other: Clothes W-: er �Medical Gas <br /> Range Hood Water rater Other: <br /> Exhaust Fan 2 Si _ Service/Bar/Mop/etc.) Other: <br /> SPRINKLER/,SUPPRESSION SYSTEM <br /> Chemical or Water I !No.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 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.lam 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 Official Use Only <br /> PERMI <br /> 11-30-17 ` \-0 * <br /> Owner/Authorized Agent Signature Date (Revised 9/23/2016) <br /> 011//. <br />