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II <br /> PERMIT APPLICATION <br /> . M 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:2902 Rucker Ave PROPERTY TAX#:00439168003300 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION / <br /> OWNER NAME: DMT Rucker LLC I TENANT BUSINESS NAME(Commercial): <br /> OWNER MAILING ADDRESS: sTREET1546T Main St# 101 ' <br /> crry Mill Cre'k STATE Y`AVA zip 98012 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME:COmfOrt Systems Northwest <br /> CONTRACTOR ADDRESS: STREET18702 North Creek Pkwy, Suite 110 <br /> cin, Bothell STATE WA ZIP 98011 <br /> CONTRACTOR PHONE:425-883-9224 CONTRACTOR EMAIL:mpomada@csusanw.com <br /> csusanw.com <br /> CONTRACTOR LICENSE#(REQUIRED):COMFOSU842LB CITY'OF EVERETT BUSINESS LICENSE#(REQUIRED): 017389 <br /> PRIMARY CONTACT: 0 OWNER D CONTRACTOR 0 OTHER(Please./Specify) <br /> CONTACT NAME: CONTACT P1-IONE:425-273-1700 <br /> Misty Pornada CONTACT EMAIL:mpomada@Csusanw.com <br /> BUILDINGG/NFORMATION <br /> Existing Use of Building:Office / Contract Price of Work:$300,000 <br /> Proposed Use of Building:Same Heat Source: OGas ❑Electric ❑Other <br /> BUILDING USE: ❑SFR ❑Townhouse ❑Duplex ❑ADU Multi-Family-'4,Units: ✓❑Commercial ❑Accessory Structure <br /> Type of Project: ❑New ❑Addition ✓❑Remodel ❑Repair ❑T.I. ❑Sign . ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: Mechanical & Plumbing scope. Installing 2 HVAC.systems, 2 RTUs, 2 Unit Heaters, 1 split system, <br /> 6 exhaust fans, 1 garage exhaust, co/no sensors, Roof hoods& GRDs. 3 Water closets, 1 urinal, 2 lays, 1 mop sink, 2 sinks, <br /> 1 floor drain, 1 HW tank, 1 sump pump, 1 electric/NH, 1 oil/water separator&piping. <br /> ASSOCIATED BUILDING PERMIT#(if applicable): //�2b 0 3-0 <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 /> 6 NC—Air Handling Units 2 Gas piping Backflow Preventer(Inside Bldg) Shower,Tub,or Combo <br /> Boiler Gays'Range Clothes Washer 4 Sink-Commercial(3-comp,prep,floor) <br /> Clothes Dryer 1 Hat Pump&Ductless Dishwasher Sink-Residential(kitchen,bath,bar) <br /> Duct System(Remodel) Aefrigeration Drinking Fountain , 1 (Sink-Utility,laundry,mop <br /> Exhaust Fans(Residential) /Commercial Ventilation 1 Floor Drain 3 Toilet <br /> Exhaust Hood(Type I) // (Not Heat/AC system) Hose Bibb 1 Urinal <br /> / <br /> Exhaust Hood(Type II) / Water Heater 1 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/Insert/Log Roof Drains 1 WaterHeater <br /> SPRINKLER/SUPPRESSION SYSTEM 1 Sewage Ejector or Sump Pump / Other: <br /> Water Suppression System No.of Heads Hot Water Tank - <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.1 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 comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> c- - iqi\f\r\op,__ Y, _ 3 20 <br /> Owne Authorized gent Signature Date (Revised 10/10/2018) <br />