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4rETT PERMIT APPLICATIO <br /> BUILDINGOECHANICAL / PLUMBING / SIGN / J 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 I (E)everetteps@everettwa gov I www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: 6000 23rd Dr W PROPERTY TAX#: 28040200301800 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Nicholson Machine &Technology Corn Corp TENANT NAME(If Commercial): Teague/Boeing <br /> OWNER MAILING ADDRESS: STREET 6000 23rd Dr W <br /> c„y Everett STATE WA ZIP 98203 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: PSF Mechanical, Inc. <br /> CONTRACTOR ADDRESS: STREET 11621 E Marginal Way S, Suite A <br /> -CITY Seattle STATE WA ZIP 98168/ � <br /> CONTRACTOR PHONE: 206-812-7683 CONTRACTOR EMAIL: permits@psfinech.com ,� <br /> CONTRACTOR LICENSE#(REQUIRED): PSFMEI*090NZ CITY OF EVERETT BUSINESS LICENSE#(REQUIRED):; 26337 j <br /> PRIMARY CONTACT: 0 OWNER 23 CONTRACTOR ❑ OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 206-812-7683 'y <br /> Amanda Moore CONTACT EMAIL: permits@psfineeh.com <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: COMMERCIAL Contract Price of Work: $87,000 <br /> Proposed Use of Building: Heat Source: ❑Ga✓ ❑Elec�fc DOther <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ' OCommercial ❑Industrial <br /> Type of Project: ONew DAddition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: <br /> Add new VRF system, (3) fan coils units, ceiling exhaust fan for AVe server closet, and OSA heat recovery unit. <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: New Addn ✓ Alteration Repair Type of Project: _New _Addn _Alteration _Repair <br /> #of #of #of #of <br /> List of Fixtures List of Fixtures List of Fixtures List,of'ixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> 3 NC—Air Handling Units Heat Pump Toilet BackfJo 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 1 Ducting Dishwasher Roof Drains <br /> Clothes Dryer Hookups _ Other: Clothes Washer; •Medical Gas <br /> Range Hood _1 _VRF system/od unit Water Heater="' Other: <br /> 1 Exhaust Fan 1 Heat recovery unit Sink(Sep/ice/Bar/Mop/etc.). Other: <br /> SPRINKLER/ SUPPRESSION SYSTEM <br /> Number 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/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 /> I City of Everett Official Use Only <br /> PER .0•01 <br /> 1 9/27/2017 M <br /> ...0 rR. .„I <br /> 0 // 7 <br /> ner/ uthorized Agent ignature Date (Revised 9/23/2016) <br /> 0 <br />