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PERMIT APPLICATION* <br /> BUILDING / ECHANICAL/PLUMBING /SIGN /SPRINKLER/ DEMOLITION <br /> /1101/-f------4 CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (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: 6700 Hardeson Rd, Suite 103 PROPERTY TAX#: 28040200401200 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> �` CONTACT INFORMATION ,,, <br /> OWNER NAME: SL Hardeson LLC TENANT NAME(If Commercial): Transdev <br /> OWNER MAILING ADDRESS: STREET PO Box 60051 <br /> crry Shoreline STATE WA ZIP 98160 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: Evergreen Refrigeration <br /> CONTRACTOR ADDRESS: STREET 727 South Kenyon St. <br /> cTv Seattle STATE WA ZIP 98108 <br /> CONTRACTOR PHONE: 206-763-1744 CONTRACTOR EMAIL: alexb@evergreenhvac.com <br /> CONTRACTOR LICENSE#(REQUIRED): EVERGRL954R2 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED):044350 <br /> PRIMARY CONTACT: ❑OWNER VCONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME:Alex Burkhart CONTACT PHONE:206-763-1744 ext. 247 <br /> CONTACT EMAIL: alexb@evergreenhvac.com <br /> ''* BUILDING PERMIT APPLICATION <br /> Existing Use of Building: Contract Price of Work: $43,619.00 <br /> Proposed Use of Building: Heat Source: El Gas ❑Electric✓DOther <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑DuplexMulti-Family-#of Units: 1�Commercial El Industrial <br /> Type of Project: ONew ❑Addition ❑Remodel ❑Repair T.I. OSign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: Installation of Five (5) Roof Exhaust Fans and Two (2) Roof Intake Hoods. <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New _ Addn VAlteration _Repair Type of Project: _New Addn Alteration _Repair <br /> #of List of Fixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> NC—Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) <br /> Forced Air Systems Unit Heater Bathtub Urinal <br /> Gas Piping Boiler Lavatory(Wash Basin) Drinking Fountain <br /> Water Heater Refrigeration Shower Floor Drain <br /> Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap <br /> Gas Range Ducting Dishwasher Roof Drains <br /> Clothes Dryer Hookups Other: Clothes Washer Medical Gas <br /> Range Hood 2 Roof Intake Hood Water Heater Other: <br /> 5 Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: <br /> SPRINKLER/SUPPRESSION SYSTEM <br /> Chemical or Water I 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.lam the owner,or lam authorized by the owner of this property to perform the work for which application is made, <br /> and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use <br /> Only <br /> 9/21/20 �� (� <br /> PERMIT# Ii, ()f yl ( V 2 Owner/Authorized Agent Signature Date (Revised 9/2 2016) 1 <br />