1812 EVERETT AVE COLUMBIA BANK 2022-02-02

PERMIT APPLICATION BUILDING MECHANICAL / PLUMBING / SIGN /##RINKLER / DEMOLITION EVERETT 32CITY OF EVERETT PERMIT SERVICES 00 CEDAR STREET, EVERETT, WA 98201 WASHINGTON (P) 425-257-8810 1 FAX 425-257-8857 1 (E) everetteps@everettwa.gov I www.everettwa.gov/permits Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS- 1 Everett Ave S16 GI� Tye, PROPERTY TAX #: LEGAL for new construction: Short Plattsubdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: Columbia Bank TENANT BUSINESS NAME (Commercial): Columbia Bank OWNER MAILING ADDRESS: STREET1 810 Everett Ave CITY Everett STATE WA zIP 98201 OWNER PHONE: 2553-3055-0718 1OWNER EMAIL:sbrockavich@columbiabank.com CONTRACTOR NAME: Nordstrom Heating & Air, Inc CONTRACTOR ADDRESS: STREET4717 87th Ave NE cI,-,, Marysville STATE WA zip 98270 CONTRACTOR PHONE:360-386-9819 ICONTMACTOR EMAIL:office@nordstromheating.com CONTRACTOR LICENSE #(REQUIRED): NORDSHA884JW ICITY OF EVERETT BUSINESS LICENSE #(REQUIRED): 042741 PRIMARY CONTACT: ❑ OWNER 121 CONTRACTOR ❑ OTHER (Please Specify) CONTACT NAME: Brad or Jason CONTACT PHONE:360-386-9819 CONTACT EMAIL:office@nordstromheating.Com BUILDING INFORMATION Existing Use of Building: Bank Contract Price of Work: $28,386.00 Proposed Use of Building:Same Heat Source: gGas ❑Electric ❑Other BUILDING USE: ❑SFR ❑Townhouse ❑Duplex OADU ❑Multi -Family - # Units: R Commercial OAccessory Structure Type of Project: ❑New ❑Addition ❑Remodel O✓ Repair OT.I. OSign OSprinkler ❑Demolition OChange of Use DESCRIPTION OF WORK: Replace to Split HVAC system with like-n-kind ASSOCIATED BUILDING PERMIT # if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Fixture Count List of Fixtures Fixture count List of Fixtures Fixture Count List of Fixtures Fixture Count List of Fixtures A/C - Air Handling Units Gas Piping Backflow Preventer (Inside Bldg) Shower, Tub, or Combo Boiler Gas Range Clothes Washer Sink -Commercial (3-comp,prep,floor) Clothes Dryer Heat Pump&Ductless Dishwasher Sink -Residential (kitchen, bath, bar) Duct System (Remodel) Refrigeration Drinking Fountain Sink -Utility, laundry, mop Exhaust Fans (Residential) Commercial Ventilatior (Not HeaVAC system) Floor Drain Toilet Exhaust Hood (Type 1) Hose Bibb Urinal Exhaust Hood (Type 11) Water Heater Interceptor -Grease Waste/Water Piping Repair Exhaust Hood (Residential) Wood Stove Interceptor-Sand/Oil Water Service (behind meter) 2 Forced Air Systems I 10ther: Medical Gas Water Valves or Fixtures Gas Fireplace/Insert/Log Roof Drains Water Heater SPRINKLER / SUPPRESSION SYSTEM ' Sewage Ejector or Sump Pump Other: Water Suppression System I lNo. of Heads Chemical Suppression System I lNo. of Heads 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 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 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, and l comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PER IT # Owner/Authorized Agent Signature Date (Revised 1011012018) i