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PERMIT APPLICATIO <br /> ILI BUILDINPMECHANICAL/PLUMBING/SIGN PRINKLER/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:14011 Airport Road Ste 102 PROPERTY TAX#:010360010100 <br /> LEGAL for new construction: Short Plat/subdivision NE 1/4 SEC23 T28N R4E Lot No. (attach copy of long legal description) <br /> CONTACT-INFORMATION <br /> OWNER NAME: RH DELTA-BEAR CREEK TENANT BUSINESS NAME(Commercial): Dunn Lumber <br /> OWNER MAILING ADDRESS: STREET PO Box 5003 <br /> cm. Bellevue STATE WA ZIP 98009 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME:Performanc 1-1 Q i fn�ll 4G '('lL• <br /> CONTRACTOR ADDRESS: STREET 1012 Central Ave S �J <br /> CITY Kent STATE WA ZIP 98032 <br /> CONTRACTOR PHONE:425-251-0356 CONTRACTOR EMAIL:kelvin.b@pmghvac.com <br /> CONTRACTOR LICENSE#(REQUIRED):PERFOHA15ORT CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 57268 <br /> PRIMARY CONTACT: ❑OWNER E CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:425-251-0356 x798 <br /> Kelvin Battle CONTACT EMAIL:kelvin.b@pmghvac.com <br /> BUILDING INFORMATION <br /> Existing Use of Building:Self storage(4 units) Contract Price of Work:$3,387.00 _ <br /> Proposed Use of Building:Telecom equipment room Heat Source: ❑Gas DElectric ❑Other _ <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: Modified existing diffusers and return for new TI.Add (1) exhaust fan to new bathroom. Connect <br /> existing exhaust. <br /> ASSOCIATED BUILDING PERMIT#(if applicable): R2011-097 <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 Water Valves or Fixtures <br /> Gas Fireplace/InserULog Roof Drains Water Heater <br /> SPRINKLER/SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other: (1) bathroom exhaust <br /> Water Suppression System I No.of Heads (4) relocate diffusers <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 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 lam authorized by the owner of this properly to perform the work for which application is made, <br /> and 1 comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> Aeg <br /> � ,,, PERMI <br /> 02, YY)21 b 4- 3A\ I Li <br /> Owner/Authorized Agent Signature Date (Revised <br /> 9 9 10/10/2018) /Z <br />