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8115 BROADWAY 2019-01-24
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8115 BROADWAY 2019-01-24
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Last modified
1/24/2019 11:59:11 AM
Creation date
1/24/2019 11:59:08 AM
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Address Document
Street Name
BROADWAY
Street Number
8115
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PERMIT APPLICATION <br /> BUILDING ECHANICAL/PLUMBING /SIGN PERINKLER/ DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwa.gov i www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS:8115 Broadway PROPERTY TAX#: <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Evergreen Building TENANT NAME(If-Commercial): <br /> OWNER MAILING ADDRESS: STREET 8115 Broadway <br /> CITY Everett STATE WA ZIP 98203 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: Berry Sign Systems <br /> CONTRACTOR ADDRESS: STREET 7400 Hardeson Rd <br /> cn-Y Everett STATE WA ZIP 98203 <br /> CONTRACTOR PHONE: 425.776.8835x114 CONTRACTOR EMAIL: tracies@berrysignsystems.com <br /> CONTRACTOR LICENSE#(REQUIRED): berryss857b7 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED):024786 <br /> PRIMARY CONTACT: 0 OWNER tZl CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 425.776.8835 x114 <br /> Tracie Skiles CONTACT EMAIL:tracies@berrysystems.com <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: Contract Price of Work:$ 12578 <br /> Proposed Use of Building: Heat Source: ❑Gas ❑Electric ❑Other <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial <br /> Type of Project: ❑New ['Addition ❑Remodel Ell Repair ❑T.I. QjSign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: <br /> install 1 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 List of Fixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> NC—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..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 lam authorized by the owner of this property to perform the work for which application is made, <br /> and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> / q(A (‘ PERMIT# <br /> 51 0\ <br /> Own r zef�rrt Signature I Date (Revised 9/23/2016) ( j <br />
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