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EVERETT <br />WASHINGTON <br />PERMIT APPLICATIOO. <br />BUILDINOMECHANICAL / PLUMBING / SIGN t SPRINKLER / DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />(P) 425-257-8810 1 FAX 425-257-8857 1 (E) everetteps@everettwa.gov I www.everettwa.gov/permits <br />(Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br />PROJECT SITE ADDRESS: 2002 Madison Street, Everett WA 98203 <br />PROPERTY TAX #: 545001-8018 <br />LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />CONTACT INFORMATION <br />OWNER NAME: Akash Mehrota TENANT BUSINESS NAME (Commercial): Everspace <br />OWNER MAILING ADDRESS: STREET 11761 162nd Ave NE <br />CITY Redmond STATE WA zip 98052 <br />OWNER PHONE: 425-802-3918 <br />OWNER EMAIL: akashmehrota@gmail.com <br />CONTRACTOR NAME: United Plumbing dba Sieh Inc. <br />CONTRACTOR ADDRESS: STREET 16778 146th St SE Suite 134 <br />CITY Monroe STATE WA zIP 98272 <br />CONTRACTOR PHONE: 360-794-5557 <br />CONTRACTOR EMAIL: <br />CONTRACTOR LICENSE #(REQUIRED): CC UNITEP*148RF <br />CITY OF EVERETT BUSINESS LICENSE #(REQUIRED): 018944 <br />PRIMARY CONTACT: ❑ OWNER El CONTRACTOR ❑ OTHER (Please Specify) <br />CONTACT NAME: <br />Dan Herman <br />CONTACT PHONE: 425-877-9701 <br />CONTACT EMAIL: dan@unitedplumbing.com <br />BUILDING INFORMATION <br />Existing Use of Building: retail <br />Contract Price of Work: $ 14688.00 <br />Proposed Use of Building: Office <br />Heat Source: ❑Gas ❑Electric ❑Other <br />BUILDING USE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi -Family - # Units: ElCommercial ❑Accessory Structure <br />Type of Project: ❑New ❑Addition ❑Remodel ❑Repair LIT. 1. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br />DESCRIPTION OF WORK: Revise DWV for 2 new baths , Janitor and Kitchen sinks. Replace water piping from meter <br />to new fixture locations. Install and trim fixtures <br />ASSOCIATED BUILDING PERMIT # (if applicable): <br />MECHANICAL <br />PERMIT <br />APPLICATION <br />PLUMBING PERMIT <br />APPLICATION <br />Fixture <br />Count <br />List of Fixtures <br />Fixture <br />count <br />List of Fixtures <br />Fixture <br />Count <br />List of Fixtures <br />Fixture <br />Count <br />List of Fixtures <br />A/C —Air Handling Units <br />Gas Piping <br />Backflow Preventer (Inside Bldg) <br />Shower, Tub, or Combo <br />Boiler <br />Gas Range <br />Clothes Washer <br />Sink -Commercial (3-comp,prep,floor) <br />Clothes Dryer <br />Heat Pump&Ductless <br />1 <br />Dishwasher <br />3 <br />Sink -Residential (kitchen,bath, bar) <br />Duct System (Remodel) <br />I Refrigeration <br />Drinking Fountain <br />1 <br />Sink -Utility, laundry, mop <br />Exhaust Fans (Residential) <br />Commercial Ventilatior <br />(Not Heat/AC system) <br />Floor Drain <br />2 <br />Toilet <br />Exhaust Hood (Type 1) <br />1 <br />Hose Bibb <br />Urinal <br />Exhaust Hood (Type 11) <br />Water Heater <br />Interceptor -Grease <br />Waste/Water Piping Repair <br />Exhaust Hood (Residential) <br />Wood Stove <br />Interceptor-Sand/Oil <br />Water Service (behind meter) <br />Forced Air Systems <br />Other: <br />Medical Gas <br />Water Valves or Fixtures <br />Gas Fireplace/Insert/Log <br />I <br />lRoof Drains <br />1 <br />Water Heater <br />SPRINKLER / SUPPRESSION <br />SYSTEM <br />Sewage Ejector or Sump Pump <br />Other: <br />Water Suppression System <br />No. of Heads <br />Chemical Suppression System <br />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 1 comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />Daniel M Herman <br />2019.09.03 09:21:07-07'00' <br />Owner/Authorized Agent Signature Date <br />City of Everett Official Use Only <br />PERMIT # ,%� V 0 �q (% <br />i <br />(Revised 1011012018) <br />