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OLT PERMIT APPLICATION <br /> BUILDING / MECHANICAL/ PLUMBING / SIGN / SPRINKLER / DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 1 FAX 425-257-8857 I(E)everetteps@everettwa.gov 1 www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: 1200 Industry Street, Everett, WA 98203 PROPERTY TAX#: 28040200402400 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: DCT Seaway Business Center LLC TENANT NAME(If Commercial): Proloois <br /> OWNER MAILING ADDRESS: STREET 1800 Wazee Street <br /> aTv Denver STATE CO ZIP 80202 <br /> OWNER PHONE: 206-414-7600 OWNER EMAIL: cduncan@prologis.com <br /> CONTRACTOR NAME: Evergreen Sign Company <br /> CONTRACTOR ADDRESS: STREET 1513 Central Ave South <br /> crry Kent STATE WA ZIP 98032 <br /> CONTRACTOR PHONE: 253-852-1354 CONTRACTOR EMAIL: danielleh@evergreensign.com <br /> CONTRACTOR LICENSE#(REQUIRED): CC EVERGSC854CO CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 56558 <br /> PRIMARY CONTACT: ❑OWNER D4 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: Danielle Holt CONTACT PHONE: 253-852-1354 <br /> CONTACT EMAIL: danielleh@evergreensign.com <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: Contract Price of Work: $ 5,067.86 <br /> Proposed Use of Building: Heat Source: ❑Gas DElectric DOther <br /> Building Type: DSFR-Detached DSFR-Attached ❑Duplex DMulti-Family-#of Units: ❑Commercial ®Industrial <br /> Type of Project: ❑New ❑Addition DRemodel DRepair ❑T.I. cilSign ❑Sprinkler ODemolition ❑Change of Use <br /> DESCRIPTION OF WORK: Excavation for installation of monument sign at entrance to 1200 Industry Street <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 II List of Fixtures #of 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 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 /> 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. 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 /> City of Everett Official Use Only <br /> . PERMIT# — <br /> T7G%yGG4X //Bit- 3/1/2019 n 0---(yyp1_.„ <br /> Owner/Authorized Agent Signature Date (Revised 9/23/2016) / <br />