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II <br /> PERMIT APPLICATION <br /> 1112 <br /> BUILDING / MECHANICAL / PLUMBING /SIGN /SPRINKLER / 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 1 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:305 SE Everett Mall Way unit 14 PROPERTY TAX#: 28051800304300 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION - <br /> r <br /> OWNER NAME: GREENTREE PLAZA TENANT BUSINESS NAME(Commer}cial)tSlgnarama <br /> OWNER MAILING ADDRESS: STREET 12411 VENTURA BLVD \-,._________ <br /> CITY STUDIO CITY STATE CA zip 91604 <br /> OWNER PHONE: (206) 636-1215 OWNER EMAIL: <br /> CONTRACTOR NAME:GS Heating & Cooling LLC <br /> CONTRACTOR ADDRESS: STREET 3409 Everett Ave <br /> CITY EverettSTATE WA ZIP 98201 <br /> CONTRACTOR PHONE:452-610-4257 CONTRACTOR EMAIL:Jonathan@gsheating.com <br /> CONTRACTOR LICENSE#(REQUIRED):GSHEAHC821 QR CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 19685 <br /> PRIMARY CONTACT: El OWNER CI CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:425-309-6507 <br /> Jonathan D Farrell CONTACT EMAIL:Jonathan@gsheating.com <br /> BUILDING INFORMATION <br /> Existing Use of Building:Retail Contract Price of Work:$4000 <br /> Proposed Use of Building:Retail Heat Source: ❑o Gas DElectric ❑Other <br /> BUILDING USE: ❑SFR ETownhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑✓Commercial ❑Accessory Structure <br /> Type of Project: ❑New EAddition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: Relocating duct work for TI <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <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 /> 8 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,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 /> City of Everett Official Use Only <br /> �// / PERMIT (� <br /> 11-111 �aNi Z /Qi2/LQ 12-12-19 �� il_ <br /> �/ <br /> w94*nerlAuthorized Agent Signature Date (Revised 10/10/2018) <br /> v7- <br />