4919 EVERGREEN WAY QFC 2017-01-13

� � � PERMIT APPLICATION BUILDIN�ECHANICAL / PLUMBING / SIGN �RINKLER / DEMOLITION CITY OF EVERETT PERMIT SERVIC 3200 CEDAR STREET, EVERETT, WA 98201 (P) 425-257-8810 � FAX 425-257-8857 �(E) everetteps(c�everettwa.qov � www.everettwa.qov/permits (Blue or Black ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: 4 91 9 Eve rgreen Way PROPERTY TAX #: O 2 6 O 9 3 5 LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: QF C# 5 0 8 5 2 TENANT NAME (If Commercial): QF C OWNERMAILINGADDRESS: srReET 1014—Vine Street arv CinCinnati sTnrE OH ziP 45202 OWNER PHONE: OWNER EMAIL: CONTRACTORNAME: Williams Mechanical Inc CONTRACTOR ADDRESS: srREET 3 9 0 3 Smi t h Ave cirv Everett srnTe WA ziP 98201 CONTRACTORPHONE: (425) 303—OH2H CONTRACTOREMAIL: info@williams—mechanical. com CONTRACTOR LICENSE #(REQUIRED): V�7 I L L I M I O 8 H PA CITY OF EVERETT BUSINESS LICENSE #(REQUIRED): O Z 6 6 S F PRIMARY CONTACT: ❑ OWNER � CONTRACTOR ❑ OTHER (Please Specify) CONTACT NAME: B r a d W i 11 i am s CONTACT PHONE: ( 2 0 0) 3 91- 0 8 0 4 CONTACT EMAIL: brad@williams—mechanical . com BUILDING PERMIT APPLICATION Existing Use of Building: Contract Price of Work: $ Proposed Use of Building: Heat Source: L�3Gas ❑Electric ❑Other Building Type: ❑SFR-Detached ❑SFR-Attached �Duplex ❑Multi-Family-# of Units: �Commercial ❑Industrial Type of Project: ❑New ❑Addition �Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: Install Area Drain and Sludge drain for Compactor ASSOCIATED BUILDING PERMIT # (if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Type of Project: _New _ Addn _Alteration _Repair Type of Project: _New _Addn X Alteration _Repair # of List of Fixtures # of List of Fixtures # of List of Fixtures # of Lisf of Fixtures Fixtures Fixtures Fixtures Fixfures A/C — Air Handling Units Heat Pump Toilet Backflow Preventer (Inside Bldg) Forced Air Systems Unit Heater Bathtub Urinal Gas Piping Boiler Lavatory (Wash Basin) Drinking Fountain Water Heater Refrigeration Shower Floor Drain Gas Fireplace Wood Stove Kitchen Sink & Disposal Grease Trap Gas Range Ducting Dishwasher Roof Drains Clothes Dryer Hookups Other: Clothes Washer Medical Gas Range Hood Water Heater Other: Exhaust Fan Sink (Service/Bar/Mop/etc.) Other: SPRINKLER / SUPPRESSION SYSTEM Number of Heads ACKNOWLEDGEMENT: 1 have reviewed this application and confirm the information contained herein is true and correct. Work done pursuant to this pe�mit 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 Ihe Building Official before being authorized under any circumstance. I am the owner, or 1 am authorized by Ihe owne� of this property to perform Ihe work for which application is made, and I comply w' S ate Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only i j PERMIT # i , �� 9-6-2016 Owne Authorize Agent Signature Date (Revised 5/20/2016)