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PERMIT APPLICATION <br /> BUILDING / MECHANICAL / PLUMBING / SIGN / SPRINKLER/ DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> OL 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 1 FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: 909 Southeast Everett Mall Way PROPERTY TAX#: 28051800300400 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: 909 Business Center LLC TENANT NAME(If Commercial): 909 Business Center Building E <br /> OWNER MAILING ADDRESS: STREET 2010 156th Avenue Northeast, Suite 100 <br /> ciTy Bellevue STATE WA zip 98007 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: Performance Mechanical Group <br /> CONTRACTOR ADDRESS: STREET 1012 Central Avenue South <br /> CITY Kent STATE WA zip 98032 <br /> CONTRACTOR PHONE: 425-251-0356 CONTRACTOR EMAIL: van.d@pmghvac.com <br /> CONTRACTOR LICENSE#(REQUIRED): PEUGHC776JJ I CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 57268 <br /> PRIMARY CONTACT: ❑OWNER El CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 425-251-0356 x927 <br /> VAN DUONG CONTACT EMAIL: van.d@pmghvac.com <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: COMMERCIAL Contract Price of Work: $ 22,462.00 <br /> Proposed Use of Building: COMMERCIAL Heat Source: ❑Gas ❑Electric DOther <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex []Multi-Family-#of Units: OCommercial ❑Industrial <br /> Type of Project: ❑New ❑Addition ©Remodel ❑Repair ❑T.I. []Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: Replace 1 existing packaged rooftop heat pump unit with new in the same place. <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New _ Addn x Alteration _Repair Type of Project: _New _Addn _Alteration _Repair <br /> #of List of Fixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> A/C—Air Handling Units 1 Heat Pump Toilet Backflow Preventer(Inside Bldg) <br /> Forced Air Systems Unit Heater Bathtub Urinal <br /> Gas Piping Boiler Lavatory(Wash Basin) Drinking Fountain <br /> Water Heater Refrigeration Shower Floor Drain <br /> Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap <br /> Gas Range Ducting Dishwasher Roof Drains <br /> Clothes Dryer Hookups Other: Clothes Washer Medical Gas <br /> Range Hood Water Heater Other: <br /> Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: <br /> SPRINKLER/SUPPRESSION SYSTEM <br /> Chemical or Water I 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 1 am authorized by the owner of this property 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 /> PERMIT# <br /> Ti <br /> L"T� " 04-10-2024 <br /> Owner/Authorized Agent Signature Date (Revised 912312016) <br />