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PERMIT APPLICATIO <br />BUILDINC�IECHANICAL I PLUMBING / SIGN RINKLER / DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />(P) 425-257-8810 � FAX 425-257-8857 �(E) everetteps@everettwa.gov � www.everettwa.gov/permits <br />PROJECT SITE INFORMATION <br />PROJECT SITE ADDRESS: PROPERTY TAX #: <br />5415 Ever reen Wa 2 2 <br />LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br />CONTACT INFORMATION <br />OWNER NAME: (;oastal C,ommuni Bank TENANT NAME (If Commercial): <br />OWNER MAILING ADDRESS: sTREET 1 2 1 A I; <br />��rY Everett sTArE Z1P <br />OWNER PHONE: OWNER EMAIL: <br />CONTRACTOR NAME: 0112riSeri M2C11ari1Cal IriC. <br />CONTRACTOR ADDRESS: srREEr 20109 144t�1 AVe NE <br />cirv sTn�E �IA Z1F' 98072 <br />CONTRACTOR PHONE: 425-481-2266 CONTRACTOR EMAIL: i l@�ohansenmech.com <br />CONTRACTOR LICENSE #(REQUIRED): c'�-��V rM'� I'%;3 �1�— CITY OF EVERETT BUSINESS LICENSE #(REQUIRED): (j2�{ Z 7 <br />PRIMARY CONTACT: ❑ OWNER I� CONTRACTOR ❑ OTHER (Please Specify) <br />CONTACT NAME: CONTACT PHONE: 425-481-2266 <br />Ivy LeVangie CONTACT EMAIL: 1 1@�ohansenmech.com <br />BUILDING PERMIT APPLICATION <br />Existing Use of Building: Banlc/OfflCes <br />Contract Price of Work: $ �`�' , 2�' V <br />Proposed Use of Building: Heat Source: ❑Gas ❑Electric ❑Other <br />Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-# of Units: �Commercial ❑Industrial <br />Type of Project: ❑New ❑Addition ❑Remodel ❑Repair [�T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br />DESCRIPTION OF WORK: <br />HVAC TI - Add 12 VAV's w/ electric heat, Add/modify duct, GRD's as needed <br />ASSOCIATED BUILDING PERMIT # (if applicable): <br />MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br />Type of Project: _New _ Addn �Alteration _Repair Type of Project: _New _Addn _Alteration _Repair <br /># of List of Fixtures #�f List of Fixtures #�f List of Fixtures # of List of Fixfures <br />Fixtures Fixtures Fixtures Fixtures <br />A/C – Air Handling Units 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 />Number of Heads <br />ACKNOWLEDGEMENT: I have reviewed this application and confirm the information contained herern 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 />� FERMIT # <br />� � �l <br />-/-� , �-�-�-y-� �-� _ _ , ,o ,1. �( j �/(1 � - L1 � > <br />Owner/Authorized Ag t Sign ur Date (Revised 10/12/2015) � <br />