5001 EVERGREEN WAY 2019-01-29 - Laserfiche WebLink

PERMIT APPLICATIOI$ BUILDING /MECHANICAL/PLUMBING/SIGN/SPRINKLER I DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 I(E)everettepsceverettwa.gov I www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: 5001 Evergreen Way,Everett WA 98203 PROPERTY TAX#:00581900001502&00581900001701 LEGAL for new construction: Short Plat/subdivision Lot No: (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: Pacwest Energy LLC TENANT NAME(If Commercial): Evergreen Shell OWNER MAILING ADDRESS: STREET 3450 Commercial Ct cmi Meridian STATE ID ZIP 83642 OWNER PHONE:Joe Sacomano(253)508-9329 Territory Manager OWNER EMAIL: joe.sacomano@jacksonenergyco.com CONTRACTOR NAME: Insignia Sign Inc. CONTRACTOR ADDRESS: STREET PO BOX 2849 CITY Renton STATE WA ZIP 98056 CONTRACTOR PHONE: (425)917-2109 CONTRACTOR EMAIL: steven@insigniasign.com CONTRACTOR LICENSE#(REQUIRED): INSIGSIO62QZ CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 038029 PRIMARY CONTACT: ❑OWNER ®CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: (425)917-2109 Steven Thomson @ Insignia Sign Inc. CONTACT EMAIL: steven@insigniasign.com BUILDING PERMIT APPLICATION Existing Use of Building:Shell Gas Station & Food Mart Contract Price of Work:$15,000.00 Proposed Use of Building:Shell Gas Station & Food Mart Heat Source: OGas ❑Electric ❑Other Building Type: ❑SFR-Detached OSFR-Attached ODuplex ❑Multi-Family-#of Units: ®Commercial ElIndustrial Type of Project: ONew DAddition ❑Remodel ❑Repair ❑T.I. ®Sign ❑Sprinkler ODemolition OChange of Use DESCRIPTION OF WORK: Nil Replace existing Shell RVI pole sign with new Shell RVIe monument sign: IN2I&IN3I Install 2 new 4'-0"x4'-0"LED illuminated Shell canopy signs(1 ON NORTH CANOPY ELEVATION&1 ON SOUTH CANOPY ELEVATION): ASSOCIATED BUILDING PERMIT#(if applicable): N4&N5 Install 2 new 2'-7 1/2"x8'-10"non-illuminated Food Mart wall signs on food mart building: MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Type of Project: _New _ Addn _Alteration _Repair Type of Project: _New _Addn _Alteration _Repair #of List of Fixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures Fixtures Fixtures Fixtures Fixtures A/C-Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) Forced Air Systems Unit Heater Bathtub Urinal Gas Piping Boiler Lavatory(Wash Basin) Drinking Fountain Water Heater Refrigeration Shower Floor Drain Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap Gas Range Ducting Dishwasher Roof Drains Clothes Dryer Hookups Other: Clothes Washer Medical Gas Range Hood Water Heater Other: Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: SPRINKLER/SUPPRESSION SYSTEM !Chemical or Water I No.of Heads 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 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 Building Official before being authorized under any circumstance.I am the owner,or lam authorized by the owner of this properly to perform the work for which application is made, and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT# b4 &ester T/.0,40.0, (Contractor&Agent) 04/04/18 OO Owner/Authorized Agent Signature Date (Revised 9/23016) Ij