505 SE EVERETT MALL WAY ASURION 2022-10-14

PERMIT APPLICATIO• BUILDING / MECHANICAL I PLUMBING/SIGN /SPRINKLER/DEMOLITION EVERETT CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 WASH INGTON (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:505 SE EVERETT MALL WAY SUITE 7 PROPERTY TAX#:28051800304800 LEGAL for new construction: Short Plat/subdivision SEC IBTNP28RGE08LOT3SSP588(GREENTREEPLAZALot No.3 (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: ASURION TECH REPAIR&SOULUTIONS TENANT BUSINESS NAME(Commercial): ASURION OWNER MAILING ADDRESS: STREET3411 169TH PLACE NE CITY ARLINGTON STATE WA zip 98223 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME:OUT FOR BID Bakti,oi h S J3 n G° CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): 6 01'I.17141 SG 9 7 Z PM CITY OF EVERETT BUSINESS LICENSE#(REQUIRED):YC E L LZ PRIMARY CONTACT: ❑OWNER O CONTRACTOR 0 OTHER(Please Specify) APPLICANT CONTACT NAME: CONTACT PHONE:804-859-0141 CHARLIANN SCHOONOVER CONTACT EMAIL:CHARLI@ETD.WEBSITE BUILDING INFORMATION Existing Use of Building:UBREAKIFIX Contract Price of Work:$4,000 Proposed Use of Building:ASURION Heat Source: OGas ❑Electric DOther BUILDING USE: OSFR ❑Townhouse ❑Duplex DADU ❑Multi-Family-#Units: ©Commercial ❑Accessory Structure Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. IZSign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: REMOVING/REPLACING EXISTING WALL SIGNS,AND REMOVING/REPLACING WINDOW VINYL 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 A/C—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 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 1 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 e/ /J � // PERMIT# 220 5 -00 3 �LGZIZ/fi c�ClLe9rL6/�4/2. 4/29/2022 Owner/Authorized Agent Signature Date (Revised 10/10/2018)