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PERMIT APPLICATION <br /> BUILDING / MECHANICAL I PLUMBING I SIGN I SPRINKLER/ DEMOLITION <br /> /11P/410,/--g CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwa.gov www.everettwa.govlpermits <br /> (Blue or Black Ink Only,Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: 1407 80TH ST SW PROPERTY TAX#: 00392200000700 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: ACHILLES USA INC TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET P 0 BOX 2287 <br /> cm( EVERETT, STATE WA ZIP <br /> OWNER PHONE: 425-353-7000 OWNER EMAIL: CBAILEY@ACHILLESUSA.COM <br /> CONTRACTOR NAME: G&S HEATING <br /> CONTRACTOR ADDRESS: STREET 3409 EVERETT AVE <br /> cm, EVERETT STATE WA zp 98201 <br /> CONTRACTOR PHONE: 425-610-4257 CONTRACTOR EMAIL: JONATHAN@GSHEATING.COM <br /> CONTRACTOR LICENSE#(REQUIRED): GSHEAC*939RK CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 19685 <br /> PRIMARY CONTACT: 0 OWNER 47 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 425-309-6507 <br /> JONATHAN FARRELL CONTACT EMAIL: JONATHAN@GSHEATING.COM <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: OFFICE Contract Price of Work:$23,000 <br /> Proposed Use of Building: OFFICE Heat Source: ❑Gas ♦Electric ❑Other <br /> Building Type: DSFR-Detached DSFR-Attached ❑Duplex ❑Multi-Family#of Units: 7Commercial ❑Industrial <br /> Type of Project: ONew ❑Addition ❑Remodel DRepair yuTJ. DSign ❑Sprinkler DDemolition ❑Change of Use <br /> DESCRIPTION OF WORK: <br /> Installing two duct less mini split systems for the heating and cooling needs of the office <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 List of Fixtures #°f List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> 44 NC—Air Handling Units Z. 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 /> Oily of Everett Official Use Only <br /> PERMI <br /> Jonathan D Farrell Z I o � <br /> Owner/Authorized Agent Signature Date (Revised 9!23/2016) <br /> \ \ 1/ <br />