4504 BROADWAY 2022-04-04 - Laserfiche WebLink

• PERMIT APPLICATIO BUILDING / MECHANICAL/ PLUMBING / SIGN /SPRINKLER/ DEMOLITION EVERETT CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 WASHINGTON (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS:4504 BROADWAY , EVERETT, WA 98203-2447 PROPERTY TAX#:00620900000002 LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: EVERGREEN FUNERAL HOME&CEMETERY TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET PO BOX 130548 cm,' HOUSTON STATE TX ZIP 77219 OWNER PHONE: (425) 252-2244 OWNER EMAIL:Leda.Westberg@Dignitymemorial.com CONTRACTOR NAME:GS Heating & Cooling LLC CONTRACTOR ADDRESS: STREET3409 Everett Ave c,T,, Everett STATE Wa zip 98201 CONTRACTOR PHONE:425-309-6507 CONTRACTOR EMAIL:Jonathan@GSheating.com CONTRACTOR LICENSE#(REQUIRED):GSHEAHC821 QR CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 19685 PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:425-309-6507 Jonathan D Farrell CONTACT EMAIL:Jonathan@gsheating.com BUILDING INFORMATION Existing Use of Building:Office Contract Price of Work:$16,000.00 Proposed Use of Building:Office Heat Source: EGas 0Electric DOther BUILDING USE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑✓Commercial ❑Accessory Structure Type of Project: New ❑Addition ❑Remodel ❑Repair T.I.❑ ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: Replacing water furnace and heat pump with new 95% Ip furnace and ac system. Running gas piping to new furnace and capping water lines to existing furnace. ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Fixture Fixture Fixture Fixture Count List of Fixtures count List of Fixtures Count List of Fixtures 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) 1 Refrigeration Drinking Fountain Sink-Utility, laundry,mop Exhaust Fans(Residential) Commercial Ventilatior Floor Drain Toilet Exhaust Hood(Type I) (Not Heat/AC system) Hose Bibb Urinal Exhaust Hood(Type II) Water Heater Interceptor-Grease Waste/Water 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 I SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other Water Suppression System No.of Heads Chemical Suppression System No.of Heads 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 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. City of Everett Official Use Only �/� PERMIT rt ln6-8-20 7Oc(O Owner/Authorized Agent Signature Date (Revised 10/10/2018)