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PERMIT APPLICATI <br />BUILDIA MECHANICAL / PLUMBING / SIG , PRINKLER / 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 St <br />PROPERTY TAX #: 545001 -8018 <br />LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br />CONTACT INFORMATION <br />OWNER NAME: Akash Mehrotra TENANT NAME (If Commercial): <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: akashmehrotra(�Pgmall.Com <br />CONTRACTOR NAME Unknown at this time - will go Out for Bid <br />CONTRACTOR ADDRESS: STREET <br />CITY STATE ZIP <br />CONTRACTOR PHONE: <br />CONTRACTOR EMAIL: <br />CONTRACTOR LICENSE #(REQUIRED): <br />CITY OF EVERETT BUSINESS LICENSE #(REQUIRED): <br />PRIMARY CONTACT: ❑ OWNER ❑ CONTRACTOR V OTHER (Please Specify) Gant Nychay - Architect <br />CONTACT NAME: <br />Joe Duzan <br />CONTACT PHONE: 206.545.9100 <br />CONTACT EMAIL: ioe@qnatnvchay.com <br />BUILDING PERMIT APPLICATION <br />Existing Use of Building: M Retail &Office SuppIV Storage) <br />Contract Price of Work: g flfl;D60 ' t t r" > .� <br />Proposed Use of Building: g (Business <br />Heat Source: OGas ❑Electric ❑Other <br />Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi -Family-# of Units: VCommercial ❑Industrial <br />Type of Project: ❑New ❑Addition ❑Remodel ❑Repair OT.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br />DESCRIPTION OF WORK: <br />Tenant Improvements / light renovation. Alterations to existing building to include: new interior walls, new windows, new ADA accessible entry <br />ASSOCIATED BUILDING PERMIT # (if applicable): <br />MECHANICAL <br />PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project: <br />_New _ Addn _Alteration _Repair <br />Type of Project: _New _Addn _Alteration _Repair <br /># of <br />Fixtures <br />List of Fixtures <br /># of <br />Fixtures <br />List of Fixtures <br /># of <br />Fixtures <br />List of Fixtures <br /># of <br />Fixtures <br />List of Fixtures <br />A/C — Air Handling Units <br />Heat Pump <br />Toilet <br />Backflow Preventer (Inside Bldg) <br />Forced Air Systems <br />Unit Heater <br />Bathtub <br />Urinal <br />Gas Piping <br />Boiler <br />Lavatory (Wash Basin) <br />Drinking Fountain <br />Water Heater <br />Refrigeration <br />Shower <br />Floor Drain <br />Gas Fireplace <br />Wood Stove <br />Kitchen Sink & Disposal <br />Grease Trap <br />Gas Range <br />Ducting <br />Dishwasher <br />Roof Drains <br />Clothes Dryer Hookups <br />Other: <br />Clothes Washer <br />Medical Gas <br />Range Hood <br />Water Heater <br />Other: <br />Exhaust Fan <br />I <br />Sink (Service/Bar/Mop/etc.) <br />Other: <br />SPRINKLER <br />/ SUPPRESSION <br />SYSTEM <br />Chemical or Water <br />No. of Heads <br />ACKNOWLEDGEMENT: 1 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 complyfwith the State Contractors Law 18.27 RCW and 296.200A WAC. <br />i City of Everett Official Use Only <br />. � . 1'9 <br />nature Date <br />PERMIT #F <br />b o� <br />(Revised 912312016) <br />Z <br />