Laserfiche WebLink
SE <br /> PERMIT APPLICATION • <br /> BUIL NG / MECHANICAL / PLUMBING /SIGN /SPRINKLER / DEMOLITION <br /> EVERETT CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> WASHINGTON (P)425-257 810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS:12902 - T HWY, SUITE E PROPERTY TAX#:28053000406700 <br /> LEGAL for new construction: Short Plat/subdivision SEC 30 TWP 28 RGE (Lot No.6 (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: LEE NORTHWEST INVESTMENT INC TENANT BUSINESS NAME(Commercial): Dr. Jade Gan <br /> OWNER MAILING ADDRESS: sTREETPO BOX 997 <br /> c,T,, Snoqualmie STATE WA ZIP 98065 <br /> OWNER PHONE: NA OWNER EMAIL: ganjade@gmail.com <br /> CONTRACTOR NAME: UNITED SYSTEMS MECHANICAL, LLC. <br /> CONTRACTOR ADDRESS: STREET 1400 AIRPORT WAY SOUTH, SUITE 202 <br /> cIT SEATTLE STATE WA ZIP 98134 <br /> CONTRACTOR PHONE:206-510-8080 CONTRACTOR EMAIL:Peter@US-Mechanical.Com <br /> CONTRACTOR LICENSE#(REQUIRED):UNITESM962QA CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 054416 <br /> PRIMARY CONTACT: ❑OWNER SCONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:206-510-8080 <br /> Peter Crelley CONTACT EMAIL:Peter@US-Mechanical.Com <br /> BUILDING INFORMATION <br /> Existing Use of Building:COMMERCIAL RETAIL Contract Price of Work: $19,200.00 <br /> Proposed Use of Building.Nn CHANGE --1I Heat Source: 0Gas 51�D Il,tric ❑O.-__ <br /> BUILDING USE: CAR nhouse plex U _-'"�'Fa #Uni-- mmercial —_cessory Structure <br /> Type of Project: dition _model pair n ange of Use <br /> DESCRIPTION OF WORK: NEW DUCTWORK DISTRIBUTION SYSTEMS OFF AN EXISTING ROOFTOP PACKAGED GAS PACK <br /> PER PLAN. INCLUDES NEW DIFFUSERS, GRILLES, FOUR NEW GENERAL EXHAUST FANS, DRYER EXHAUST DUCTWOI <br /> AND THREE NEW ROOF PENETRATIONS. //�, <br /> ASSOCIATED BUILDING PERMIT#(if applicable): I 3 J 0 (��`� <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 /> Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility,laundry,mop <br /> 4 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 /> 1EVf/�I``V/j�T# <br /> �/� 9/23/2019 P • • \ n n O <br /> Owner/Authorized Agent gnature Date (Revised 10/10/2018) <br />