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PERMIT APPLICATION <br /> BUILDING ECHANICAL/ PLUMBING /SIGN *WINKLER/ DEMOLITION <br /> #111#401 ----ACITY OF EVERETT PERMIT SERVICES <br /> y_' 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: 1 010 Everett Mall Way PROPERTY TAX#: <br /> v <br /> LEGAL for new construction: Short Pla subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: VetCenter TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 1010 Everett Mall Way <br /> cm(Everett STATE WA ZIP 98208 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: Berry Sign Systems <br /> CONTRACTOR ADDRESS: STREET 7400 Hardeson Rd <br /> crw 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: ❑OWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 425.776.8835 x114 <br /> Tracie Skiles CONTACT EMAIL:tracies@berrysystems.Cont <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: Contract Price of Work:$5856 <br /> Proposed Use of Building: Heat Source: ❑Gas ❑Electric ❑Other <br /> Building Type: ❑SFR-Detached ['SFR-Attached CI Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial <br /> Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. I4 Sign ❑Sprinkler ODemolition ❑Change of Use <br /> DESCRIPTION OF WORK: <br /> install 1 wall sign on existing brackets <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.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 I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> �� <br /> City of Everett Official Use Only <br /> /L!// PERMIT#� C <br /> Owne horiz en ture Date �� (Revised 9/23/2016) fllJ �(( <br />