1809 100TH PL SE 2022-04-29 - Laserfiche WebLink

MIN PERMIT APPLICATION BUILDINGIlk CHANICAL/ PLUMBING /SIGN / SAIIIKLER/ 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: 1809 100TH PL SE PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: BRENT KELLOGG TENANT BUSINESS NAME(Commercial): SILVER LAKE DENTAL ARTS OWNER MAILING ADDRESS: STREET 1 809 100TH PL SE crry EVERETT STATE WA ZIP 98208 OWNER PHONE:4253501642 OWNER EMAIL:BNKELLOGG@FRONTIER.COM CONTRACTOR NAME: LEGACY ONE HEATING CONTRACTOR ADDRESS: sTREET4463 RUSSELL RD #103 or, MUKILTEO STATE WA ZIP 98275 CONTRACTOR PHONE:4253747052 CONTRACTOR EMAIL:OFFICE@LEGACYONEHEATING.NET CONTRACTOR LICENSE#(REQUIRED):LEGACOH845L3 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 61 266 PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:4257734569 KARL CHRISTENSEN CONTACT EMAIL:KARL@LEGACYONEHEATING.NET BUILDING INFORMATION Existing Use of Building:COMMERCIAL Contract Price of Work: $19967.00 Proposed Use of Building: Heat Source: OGas Electric ❑Other BUILDING USE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: OCommercial ❑Accessory Structure Type of Project: :New ❑Addition ORemodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: We will be replacing current unit with a 5-ton Air handler and Heat pump/AC system- 14SEER with duct system 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 NC—Air Handling Units Gas Piping Backflow Preventer(Inside Bldg) Shower,Tub,or Combo Boiler Gas Range Clothes Washer Sink-Commercial(3-comp,prep,floor) Clothes Dryer 1 Heat Pump&Ductless Dishwasher Sink-Residential(kitchen,bath,bar) Duct System(Remodel) 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/ 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 1 comp w h the State Contractors Law 18.27 RCW and 296.200A WAC. f City of Everett Official Use Only ' nM�# 1013 2 PE 0 Ent `t 2c2) 0 r (ie, 0 e IA • eckAr Si ature Date (Revised 10/10/2018) /�