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PERMIT APPLICATION <br /> BUILDING/MECHANICAL/ PLUMBING/SIGN/SPRINKLER/ DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> W.,- <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 ((E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> tiliir�I� -c` °7.�*`i. -a't .k+^a' { ;�- `- r�,° .. — s ","-''^"xJ =`N jt1 rkRd tk #G'N t <br /> PROJECT SITE ADDRESS: 3632 BROADWAY AVE PROPERTY TAX#: 00437388001700 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> r r, _;, CONT`ICT INFORMATIO"l( ' <br /> OWNER NAME: VAN WINKLE PROPERTIES LLC TENANT NAME(If Commercial): STADIUM FLOWERS <br /> OWNER MAILING ADDRESS: STREET 2410 38TH ST <br /> crr, EVERETT STATE WA ZIP 98201 <br /> OWNER PHONE: 425-766-6086 OWNER EMAIL:darla@stadiumflowers.com <br /> CONTRACTOR NAME: TBCS him/f y f m/ (OK, CIA <br /> CONTRACTOR ADDRESS: "� STREET <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): <br /> PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR �d, r <br /> OTHER(Please Specify) Project Manager <br /> CONTACT NAME: CONTACT PHONE:425-252-2153 <br /> MATT SCHREIFELS CONTACT EMAIL: MATTS@2812ARCHITECTURE <br /> Z T K Y' ` ' BUILDING PERMIT APPLICATION . <br /> Existing Use of Building:559 Other Retail Contract Price of Work:$150,000 -101000 1 4DI EOO <br /> Proposed Use of Building:559 Other Retail Heat Source: QlGas ❑Electric ❑Other <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: EaCommercial El Industrial <br /> Type of Project: :New ❑Addition ❑Remodel ❑Repair T.I.0 ❑Sign ❑Sprinkler El Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: <br /> Relocate existing walk-in-cooler, remodel/update floral design area, employee break room & retail space <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> ri.** ICA..PERMIT APPLICATION040icy;y; .4LUMBIN *ERM:0 APPLIC,0-(0N'" L`'i'.1 r MIV <br /> Type of Project: _New _ Addn ✓Alteration _Repair Type of Project: _New _Addn )Alteration _Repair <br /> #of #of List of Fixtures List of Fixtures #of List of Fixtures #°f List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> A/C–Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) <br /> Forced Air Systems Unit Heater tub Urinal <br /> Gas Piping Boiler Lavato1 (_Wash Basin) Drinkin untain <br /> Water Heater Refrigeration Shower F rain <br /> Gas Fireplace Wood Stove I Kitchen Sink&Dis.. .1 ----Grease Trap <br /> Gas Range Ducting Dishwasher Roof Drains <br /> Clothes Dryer Hookups Other: Clothes Washer ✓ Medical Gas <br /> Range Hood Water Heater O - : <br /> Exhaust Fan Sink(Servi ar/Mop/etc.) Other: <br /> SPRINKLER!;SUPPRESSION 0:STEI41 <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 I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> ;ter- 9)10)1I <br /> `..--sir• 1t <br /> Ownethoriied Agent Signatu = P'�'� <br /> r/AaDate (Revised 9/23/2016) <br />