1020 N BROADWAY LILLYS GARDEN 2019-02-05

PERMIT APPLICATION BUILDING/MECHANICAL/PLUMBING /SIGN/SPRINKLER/DEMOLITION CITY OF EVERETT PERMIT SERVICES y 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwa.gov 1 www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: 1020 N Broadway PROPERTY TAX#: 29051700203200 LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: Koz on N Broadway IIc TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET 1830 Bickford Avenue, Suite 201 CITY Snohomish STATE VV,^I A ZIP 98290 OWNER PHONE: 206.755.1290 OWNER EMAIL: josh@kozdevelopment.com CONTRACTOR NAME: Wyser Construction Co Inc. CONTRACTOR ADDRESS: STREET 19015 109th Ave SE CITY Snohomish STATE WA ZIP 98296 CONTRACTOR PHONE: 206-510-0672 CONTRACTOR EMAIL: dan@wyserdirt.com CONTRACTOR LICENSE#(REQUIRED): WYSERCIO45N9 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 34326 PRIMARY CONTACT: 0 OWNER pCONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 206-510-0672 Dan Reynolds CONTACT EMAIL: dan@wyserdirt.com BUILDING PERMIT APPLICATION Existing Use of Building: Restaurant Contract Price of Work:$ 5,O EDO- °.„..9- Proposed Proposed Use of Building: Heat Source: ❑Gas ❑Electric ❑Other Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler (Demolition ❑Change of Use DESCRIPTION OF WORK: Demolition of an existing structure ("Lilly's Garden"). ASSOCIATED BUILDING PERMIT#(if applicable): 81804-011 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 NC—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 I am authorized by the owner of this property 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 057/C70 PERMIT# ^ ' l/„)S a/—) Owner/Authorize Agent Signature e (Revised 9/23/2016)