5415 EVERGREEN WAY COASTAL COMMUNITY BANK 2022-02-02

EVERETT WASHINGTON PERMIT APPLICATIO*/RINKLER BUILDING R ECHANICAL / PLUMBING / SIGN / DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (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: 5415 vergreen Way PROPERTY TAX #: 00393200100502 LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: Coastal Bank TENANT BUSINESS NAME (Commercial): OWNER MAILING ADDRESS: s.REET 10520 19th Ave SE CITY Everett STATE WA Z,P 98208 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: Johansen Mechanical, Inc. CONTRACTOR ADDRESS: STIEET20109 144th Ave Ne CITY Woodinville STATE WA ZIP 98072 CONTRACTOR PHONE: 425-481-2266 CONTRACTOR EMAIL: ivyl@johansenmech.com CONTRACTOR LICENSE #(REQUIRED): JOHANM1173PK CITY OF EVERETT BUSINESS LICENSE #(REQUIRED): 024276 PRIMARY CONTACT: ❑ OWNER El CONTRACTOR ❑ OTHER (Please Specify) CONTACT NAME: Ivy LeVangie CONTACT PHONE: 425-481-2266 CONTACT EMAIL: ivyl@johansenmech.com BUILDING INFORMATION Existing Use of Building: Contract Price of Work: $ 35,159 Proposed Use of Building: Heat Source: ❑Gas ❑Electric ❑Other BUILDING USE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi -Family - # Units: ❑Commercial ❑Accessory Structure Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: HVAC Improvements - modify existing ductwork, relocate existing and provide new grilles 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) 1I Duct System (Remodel) Refrigeration Drinking Fountain Sink -Utility, laundry, mop Exhaust Fans (Residential) Commercial Ventilatio (Not Heat/AC system) Floor Drain Toilet Exhaust Hood (Type 1) Hose Bibb Urinal Exhaust Hood (Type II) Water Heater Interceptor -Grease Waste/Water Piping Repair Exhaust Hood (Residential) Wood Stove Interceptor-Sand/Oil Water Service (behind meter) Forced Air Systems 36 Other: Grilles Medical Gas Water Valves or Fixtures Gas Fireplace/Insert/Log I I Roof Drains Water Heater SPRINKLER / SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other: Water Suppression System No. of Heads Chemical Suppression System I No. 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 I comply with the to Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only M1 %5 INki D (Revised 10/10/2018) C� Owner/AuthorizedXgent Signature 5/4/20 Date