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Revised 9/15/2016 CITY OF WENATCHEE TENANT IMPROVEMENT PERMIT APPLICATION DEPARTMENT OF COMMUNITY DEVELOPMENT 1350 MCKITTRICK ST., SUITE A, WENATCHEE, WA 98801 Building Department (509) 888-3244 Inspection Line (509) 888-3263 Fax (509) 888-3201 DATE APPLIED PERMIT NO. JOB SITE ADDRESS: JOB SITE PHONE LEGAL DESCRIPTION: PARCEL NO. NATURE OF WORK: VALUATION (LABOR AND MATERIALS) $ TYPE OF USE: Commercial Industrial Other BUSINESS NAME: ______________________________________________________________ OCCUPANCY TYPE: ___________________ APPLICANT’S NAME: CONTACT NAME:____________________________ PRIMARY PHONE: ( )__________________ MAILING ADDRESS: (STREET, P.O., CITY, STATE, ZIP) ALT PHONE: ( )______________________ EMAIL: _____________________________________ OWNER’S NAME: CONTACT NAME:____________________________ PRIMARY PHONE: ( )__________________ MAILING ADDRESS: (STREET, P.O., CITY, STATE, ZIP) ALT PHONE: ( )______________________ EMAIL: _____________________________________ CONTRACTOR’S NAME: (copy of contractor’s registration card required): CONTACT NAME:____________________________ PRIMARY PHONE: ( )__________________ MAILING ADDRESS: (STREET, P.O., CITY, STATE, ZIP) ALT PHONE: ( )______________________ EMAIL: _____________________________________ CONTRACTOR’S LICENSE NUMBER: EXPIRATION DATE: CITY BUSINESS LICENSE NUMBER: EXPIRATION DATE: ARCHITECT/DESIGNER’S NAME: CONTACT NAME:____________________________ PRIMARY PHONE: ( )__________________ MAILING ADDRESS: (STREET, P.O., CITY, STATE, ZIP) ALT PHONE: ( )______________________ EMAIL: _____________________________________ LENDING AGENCY / CONTRACTOR’S BONDING FIRM: (If applicable, per RCW 19.27.095) CONTACT NAME:____________________________ PHONE: ( ) _________________________ MAILING ADDRESS: (STREET, P.O., CITY, STATE, ZIP) Cash Check No. : __________________ Plan Check Fee: $________________________ Receipt No: Is structure fifty years old or older? Is structure on a historic register? Is structure in a historic district? Is structure in Central Business District? Yes  No  Yes  No  Yes  No  Yes  No  By signing below, I certify that the information provided with this application herein is true and accurate. I further certify that any and all work performed shall be done in accordance with the ordinances and laws of the City of Wenatchee. Applicant Signature Authorized Agent Signature Print Name Print Name PERMIT APPLICATIONS ARE ACCEPTED MONDAY - FRIDAY FROM 8:00 AM TO 4:30 PM. FEES ARE COLLECTED AT THE TIME OF PERMIT SUBMITTAL. 1616 North Wenatchee Avenue T 23N R 20EWM S 33 PARCEL 1 LESS PT TO RTW 1.6100 ACRES PARCEL 1 LESS PT TO RTW 232033140950 X Grocery Outlet Teresa Jones 6700 Antioch Plaza, Suite 300 Merriam, KS 66204 Grocery Outlet (Business Owner) Harlan D & Maxine H Douglass (Property Owner)