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EVERETT <br />WASHINGTON <br />PERMIT APPLICATIC <br />BUILDIN MECHANICAL / PLUMBING / SIGAPRINKLER / 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: 1010 SE EVERETT MALL WAY <br />PROPERTY TAX #: 28051800306600 <br />LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br />CONTACT INFORMATION <br />OWNER NAME: EVERETT MALL OFFICE BUILDING LLC TENANT BUSINESS NAME (Commercia : NORTHWEST KIDNEY CENTERS <br />OWNER MAILING ADDRESS: STREET 1010 SE EVERETT MALL WAY STE 102 <br />ciTv EVERETT STATE WA ZIP 98208 <br />OWNER PHONE: <br />OWNER EMAIL: <br />CONTRACTOR NAME: ACCO ENGINEERED SYSTEMS <br />CONTRACTOR ADDRESS: STREET5300 DENVER AVE S <br />CITY SEATTLE STATE WA ZIP 98108 <br />CONTRACTOR PHONE: 206-787-8500 <br />CONTRACTOR EMAIL: <br />CONTRACTOR LICENSE #(REQUIRED): ACCOES1971 DU <br />CITY OF EVERETT BUSINESS LICENSE #(REQUIRED): 37887 <br />PRIMARY CONTACT: ❑ OWNER 0 CONTRACTOR ❑ OTHER (Please Specify) <br />CONTACT NAME: <br />KEVIN KRUEGER <br />CONTACT PHONE: 206-636-5269 <br />CONTACT EMAIL: KKRUEGER@ACCOES.COM <br />BUILDING INFORMATION <br />Existing Use of Building: BUSINESS <br />Contract Price of Work: $ 94,143 <br />Proposed Use of Building: BUSINESS <br />Heat Source: []Gas ❑Electric ❑� Other HEAT PUMP <br />BUILDING USE: ❑SFR []Townhouse ❑Duplex ❑ADU ❑Multi -Family - # Units: ❑✓ Commercial ❑Accessory Structure <br />Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑✓ T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br />DESCRIPTION OF WORK: ALL EQUIPMENT SERVING SCOPE OF WORK IS TO BE REPLACED LIKE FOR LIKE. <br />PROVIDE NEW LOW PRESSURE DUCTWORK, GRILLES, AND THERMOSTATS FOR TI SCOPE. <br />ASSOCIATED BUILDING PERMIT # (if appli ): <br />MECHANICAL <br />PERMIT <br />APP <br />CATION <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 />10 <br />Heat Pump&Ductless <br />Dishwasher <br />Sink -Residential (kitchen, bath, bar) <br />9 <br />Duct System (Remodel) <br />1 <br />Refrigeration <br />Drinking Fountain <br />Sink -Utility, laundry, mop <br />Exhaust Fans (Residential) <br />3 <br />Commercial Ventilation <br />(Not Heat/AC system) <br />Floor Drain <br />Toilet <br />Exhaust Hood (Type 1) <br />Hose Bibb <br />Urinal <br />Exhaust Hood (Type II) <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 />l0ther <br />Medical Gas <br />Water Valves or Fixtures <br />Gas Fireplace/Insert/Log <br />I <br />Roof Drains <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 I complyvith the State Contractors Law 18.27 RCW and 296.200A WAC. <br />Agent Signature <br />01/10/2020 <br />Date <br />City of Everett Official Use Only <br />Pm,�( — 02-19 <br />(Revised 1011012018) 7 <br />