4925 EVERGREEN WAY BELLA CLEANERS 2022-02-02

• PERMIT APPLICATION* EVERETT WASHINGTON BUILDING / MECHANICAL / PLUMBING / SIGN / SPRINKLER / 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:4925 EVERGREEN WAY UNIT 925 PROPERTY TAX #: 00581900000101 LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: CLAREMONT VILLAGE STATION LLC TENANT BUSINESS NAME (Commercial): BELLA CLEANERS OWNER MAILING ADDRESS: STREET 11501 NORTHLAKE DR cITY CINCINNATI STATE OH zip 45249 OWNER PHONE: 801-415-4359 OWNER EMAIL: aregal@phillipsedison.com CONTRACTOR NAME: GS HEEATING & COOLING LLC CONTRACTOR ADDRESS: STREET 3409 EVERETT AVE CITY EVERETT STATE WA zIP 98201 CONTRACTOR PHONE: 425-610-4257 CONTRACTOR EMAIL: JONATHAN@GSHEATING.COM CONTRACTOR LICENSE #(REQUIRED): GSHEAHC821 QR CITY OF EVERETT BUSINESS LICENSE #(REQUIRED): 19685 PRIMARY CONTACT: ❑ OWNER 0 CONTRACTOR ❑ OTHER (Please Specify) CONTACT NAME: JONATHAN D FARRELL CONTACT PHONE: 425-309-6507 CONTACT EMAIL:JONATHAN@GSHEATING.COM BUILDING INFORMATION Existing Use of Building: Cleaners Contract Price of Work: $ 13,000.00 Proposed Use of Building: Cleaners Heat Source: OGas ❑Electric ❑Other BUILDING USE: ❑SFR ❑Townhouse E]Duplex ❑ADU ❑Multi -Family - # Units: ✓❑Commercial ❑Accessory Structure Type of Project: ❑New ❑Addition ❑Remodel ❑Re air ❑T.I. ❑Sin ❑Sprinkler ❑Demolition ❑Chan e of Use DESCRIPTION OF WORK: Replacing roof top unit and stat with like in kind system 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 1 A/C — Air Handling Units 1 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 Heat/AC system) Floor Drain Toilet Exhaust Hood (Type 1) Hose Bibb Urinal Exhaust Hood (Type II) Water Heater Interceptor -Grease WastefWater Piping Repair Exhaust Hood (Residential) Wood Stove Interceptor-Sand/Oil Water Service (behind meter) Forced Air Systems Other: 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 No. of Heads Chemical Suppression System No. of Heads ACKNOWLEDGEMENT. 1 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 State Contractors Law 18.27 RCW and 296.200A WAC. Agent Signature 3-11-2020 Date City of Everett Official Use Only PERMI # 2d -D (Revised 1011012018) I �