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PERMIT APPLICATIOI I <br /> BUILDINC IECHANICAL / PLUMBING / SIGN =='RINKLER / DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 (E)everetteps@everettwa.gov www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: 909 SE EVERETT MALL WAY PROPERTY TAX#: 28051800300400 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) SEE ATTACHED <br /> CONTACT INFORMATION <br /> OWNER NAME: 909 BUSINESS CENTER LLC TENANT NAME(If Commercial): 909 BUSINESS CENTER LLC <br /> OWNER MAILING ADDRESS: STREET 2010 156TH AVE NE, STE 100 <br /> crri BELLEVUE, STATE WA ZIP 98007 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME Performance Mechanical Group <br /> CONTRACTOR ADDRESS: STREET 1012 Central Avenue South <br /> crr Kent STATE WA ZIP 98032 <br /> CONTRACTOR PHONE: 425-251-0356 CONTRACTOR EMAIL: eric.o@pmghvac.com <br /> CONTRACTOR LICENSE#(REQUIRED): PERFOHA15ORT CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 57268 <br /> PRIMARY CONTACT: ❑ OWNER CONTRACTOR ❑ OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 425-251-0356 <br /> Eric O'Keefe CONTACT EMAIL: eric.o©pmghvac.corn <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: Medical Offices Contract Price of Work: $ $15,000.00 <br /> Proposed Use of Building: na Heat Source: Gas {rlElectric ❑Other <br /> Building Type: ❑SFR-Detached ❑SFR-Attached Duplex ❑Multi-Family-#of Units: VCommercial ❑Industrial <br /> Type of Project: ❑New ❑Addition ❑Remodel ORepair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: <br /> Replace existing roof top package unit with new unit of same capacity. <br /> New roof top package unit to be installed in same location. <br /> ASSOCIATED BUILDING PERMIT#(if applicable): NA I'. ) <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 #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 1 Package Unit 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. 1 am the owner, or I am authorized by the owner of this property to perform the work for which application is made, <br /> and/comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> PERMIT /� <br /> Eric O'Keefeo�,....a �o. .... 6/12/2019 I L��j )7 <br /> Owner/Authorized Agent Signature Date (Revised 9/23/2016) a� <br />