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air PERMIT APPLICATI <br /> BUILDIIIu I MECHANICAL / PLUMBING / SIGN , SPRINKLER/ DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I (E)everettepsianverettwa.gov I www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: 6220 Evergreen Way PROPERTY TAX#: 0181 61 0 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Value Village #1021 TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 12720 Hillcrest Rd # 900 <br /> CITY Dallas STATE TX ziP 75230 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: Comfort Systems Northwest <br /> CONTRACTOR ADDRESS: STREET 18702 North Creek Pkwy, Suite 110 <br /> CITY Bothell STATE WA ZIP 98011 <br /> CONTRACTOR PHONE: 425-883-9224 CONTRACTOR EMAIL: misty.pomada@comfortsystemsusa. corn <br /> CONTRACTOR LICENSE#(REQUIRED): COMFO S U 8 4 2 LB CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 017389 <br /> PRIMARY CONTACT: 0 OWNER COCONTRACTOR ❑ OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: .425-883-9224 <br /> Misty Pomada CONTACT EMAIL: misty.pomada@comfortsystemsusa.com <br /> BUILDING PERMIT APPLICATION �/ry <br /> Existing Use of Building: Contract Price of Work: $ k.49 COO <br /> Proposed Use of Building: Heat Source: ❑Gas ❑Electric ❑Other <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑ gmmercial ❑Industrial <br /> Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolitio - Change of Use <br /> DESCRIPTION OF WORK: <br /> Replacing 2 RTUs with new . QLF04 .", <br /> /WO r( <br /> CITY OFEV :�c .�.._� <br /> ASSOCIATED BUILDING PERMIT#(if applicable): rPe(-9�?f _' , ,. <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New _ Addn Alteration X Repair Type of Project: New Addn _Alteration _Repair <br /> #of #of <br /> List of Fixtures #of List of Fixtures #of List of Fixtures List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> NC—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 /> 2 RTUs <br /> SPRINKLER/ SUPPRESSION SYSTEM <br /> Chemical or Water I No. of Heads <br /> ACKNOWLEDGEMENT:1 have reviewed this application and confirm the information contained herein is tnie 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 /> r City of Everett Official Use Only <br /> �f C* -- `1�.�.. � D .3" , PERMIT#M ,,S10 -03 <br /> wneer//Authoriz Agent Signature Date (Revised 9/23/2016) I <br />