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PERMIT APPLICATICIE <br /> BUILDIN—ImIIECHANICAL/ PLUMBING/SIGMWRINKLER/ DEMOLITION <br /> E V E R E T TCITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> WASHINGTON (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwa.gov 1 www.everettwa.gov/permits <br /> (Blue or Black Ink.Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS:3120 McDougall PROPERTY TAX#:00439074201 100 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: United Way of Snohomish County TENANT BUSINESS NAME(Commercial): YMCA of Snohomish <br /> OWNER MAILING ADDRESS: STREET3120 McDougall Ave <br /> CITY Everett STATE WA Zip 98201 <br /> OWNER PHONE: 425-374-5500 OWNERrrEMAIL: <br /> CONTRACTOR NA j1/4U �Uk..p� ((' -C..�1 <br /> CONTRACTOR ADDRESS: STREE 2_6a 1 v <br /> a11 <br /> CITY 8u1.1o` / ..1� STATE WA ZI <br /> P CQ <br /> ���"`��� <br /> CONTRACTOR PHONE:425-531-9914 CONTRACTOR EMAIL:Noah.Martin@gly.com ��� <br /> CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUI D): <br /> PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONES-991'4 -215 14<g-2,_ G' <br /> Lp I4Gg' C � 10, <br /> � L- <br /> V ,‘-- CONTACT EMAIL:No311kda gircnm v A012,11-4 <br /> BUILDING INFORMATIO �, � �,�D <br /> Existing Use of Building:Office Contract Price .f Work:$32,400.00 <br /> Proposed Use of Building:Office Heat Source: al Gas ❑Electric ❑* er <br /> BUILDING USE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: -. -rcial EAccessory Structure <br /> Type of Project: New ❑Addition ✓❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: Leaving existing roof top package units in place and redoing existing duct work to accomidate <br /> new office lay out. Install three zone dampers <br /> ASSOCIATED BUILDING PERMIT#(if applicable): 81907-035 <br /> MECHANICAL PERMIT APPLICATION .'' PLUMBING PERMIT APPLICATION <br /> Fixture Fixture Fixture Fixture <br /> Count List of Fixtures Count List of Fixtures Count List of Fixtures Count List of Fixtures <br /> A/C-Air Handling Units Gas Piping Backflow Preventer(Inside Bldg) Shower,Tub,or Combo <br /> Boiler Gas Range Clothes Washer Sink-Commercial(3-comp,prep,floor) <br /> Clothes Dryer Heat Pump&Ductless Dishwasher Sink-Residential(kitchen,bath,bar) <br /> 36 Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility,laundry,mop <br /> Exhaust Fans(Residential) Commercial Ventilation Floor Drain Toilet <br /> Exhaust Hood(Type I) (Not Heat/AC system) Hose Bibb Urinal <br /> Exhaust Hood(Type II) Water Heater Interceptor-Grease Waste/Water Piping Repair <br /> Exhaust Hood(Residential) Wood Stove Interceptor-Sand/Oil Water Service(behind meter) <br /> Forced Air Systems Other: Medical Gas Water Valves or Fixtures <br /> Gas Fireplace/Insert/Log Roof Drains Water Heater <br /> SPRINKLER/SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other: <br /> Water Suppression System No.of Heads <br /> Chemical Suppression System 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,ort am authorized by the owner of this property to perform the work for which application is made, <br /> and 1 comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> ` <br /> Mark Templeton rPERMIT az.L( <br /> ���.n"°"°"'"""'"""""""""°'"a""°"'°"°°":".°"'"""""`"."�.."'"." 8/27/2019 <br /> Owner/Authorized Agent Signature Date (Revised 10/10/2018) <br />