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• <br /> ® PERMIT APPLICATION <br /> BUILDING / MECHANICAL/ PLUMBING /SIGN /SPRINKLER/ DEMOLITION <br /> EVERETT CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> WASHINGTON (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE.INFORMATION <br /> PROJECT SITE ADDRESS:2121 W Casino Rd, Everett, WA 98204 PROPERTY TAX#: 28041400202500 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: TENANT BUSINESS NAME(Commercial): WSPIC <br /> OWNER MAILING ADDRESS: sTREET2121 W Casino Rd <br /> cry Everett STATE WA zip 98204 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME:Evergreen Eastside Heat and AC , —ALA Dfs 1/1,1rr lMy..P 4 () <br /> CONTRACTOR ADDRESS: STREET 1811 130th Ave NE Suite 101 <br /> cm Bellevue STATE WA zip 98005 <br /> CONTRACTOR PHONE:(425) 968 8702 CONTRACTOR EMAIL:admin@eeheatac <br /> CONTRACTOR LICENSE#(REQUIRED):EVERGSS928RN CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 007955 <br /> PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR 0 OTHER(Please Specify) Project Manager <br /> CONTACT NAME: CONTACT PHONE:(425) 968 8702 <br /> Carrie Durnell CONTACT EMAIL:carrie@eeheatac.com <br /> BUILDING INFORMATION <br /> Existing Use of Building:Office Building Contract Price of Work:$83,625 <br /> Proposed Use of Building:Office Building Heat Source: OGas DElectric ❑Other <br /> BUILDING USE: DSFR ❑Townhouse ❑Duplex ❑ADU ❑Multi Family-#Units: Cl commercial ❑Accessory Structure <br /> Type of Project: ONew ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign OSprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: Install new Liebert Cooling Roof top system <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Fixture Fixture Fixture Fixture <br /> Count List of Fixtures Count List of Fixtures Count List of Fixtures Count List of Fixtures <br /> NC—Air Handling Units Gas Piping Backflow Preventer(Inside Bldg) Shower,Tub,or Combo <br /> Boiler Gas Range Clothes Washer Sink-Commercial(3-comp,prep,floor) <br /> Clothes Dryer Heat Pump&Ductless Dishwasher Sink-Residential(kitchen,bath,bar) <br /> Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility,laundry,mop <br /> Exhaust Fans(Residential) Commercial Ventilatior Floor Drain Toilet <br /> Exhaust Hood(Type I) (Not Heat/AC system) Hose Bibb Urinal <br /> Exhaust Hood(Type II) Water Heater Interceptor-Grease Waste/Water Piping Repair <br /> Exhaust Hood(Residential) Wood Stove Interceptor-Sand/Oil Water Service(behind meter) <br /> Forced Air Systems Other: Medical Gas a Ives or Fixtures <br /> Gas Fireplace/Insert/Log Roof Drains Water Hea <br /> SPRINKLER/SUPPRESSION SYSTEM Sewage ' or Sump P mp I Other: L i 8 bet 4 Cu o I i n <br /> Water Suppression System No.of Heads S a9 5few '. <br /> Chemical Suppression System No.of Heads <br /> ACKNOWLEDGEMENT..I have reviewed this application and confirm the information contained herein is true and correct. Work doh an to this permhit-A <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 ply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> q /� nI� ``ll (�lCiitty of Everett Official Use Only <br /> i/ PE�� �J v�- 0 <br /> v <br /> n u oriz A ignature Date (Revised 10/10/2018) /..) <br />