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41477- PERMIT APPLICATION <br /> BUILDING / MECHANICAL/ PLUMBING /SIGN / SPRINKLER / DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 1 FAX 425-257-8857 1 (E)everetteps@everettwa.gov 1 www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJ TE ADD gg PROPERTY TAX#: <br /> 332 SW Everett Mall Way 28042400100700 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Integon National Insurance Co TENANT NAME(If Commercial): National General Insurance <br /> OWNER MAILING ADDRESS: STREET 59 Maiden Ln 38th FL <br /> CITY New York STATE NY ZIP 10038 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: Johansen Mechanical, Inc. <br /> CONTRACTOR ADDRESS: STREET 20109 144th Ave NE <br /> CITY Woodinville STATE WA ZIP 98072 <br /> CONTRACTOR PHONE: 425-481-2266 CONTRACTOR EMAIL: ivylOjohansenmech.com <br /> CONTRACTOR LICENSE#(REQUIRED): JOHANMI173PK CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): O 2,4 27 Io <br /> PRIMARY CONTACT: ❑OWNER CR CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 425-481-2266 <br /> Ivy LeVangie CONTACT EMAIL: ivyl@johansenmech.com <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: Office Contract Price of Work:$ 240,794 <br /> Proposed Use of Building: Same Heat Source: as DElectric DOther <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ODuplex DMulti-Family-#of Units: ESICommercial ❑Industrial <br /> Type of Project: ❑New DAddition DRemodel ❑Repair LCIT.I. ❑Sign DSprinkler DDemolition ❑Change of Use <br /> DESCRIPTION OF WORK: <br /> HVAC system TI install 2 new rooftop units, ductwork grilles and accessories per plans. <br /> ASSOCIATED BUILDING PERMIT#(if applicable): 1 <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 #of List of Fixtures #of List of Fixtures #°f List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> 2 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 1 Ducting Dishwasher Roof Drains <br /> Clothes Dryer Hookups 4 Other: VAV'S _Clothes Washer Medical Gas <br /> Range Hood 220 Grilles 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 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 I am authorized by the owner of this property to perform the work for which application is made, <br /> and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> Owner/Authorize..,ge Signa ure ate (Revised 10/12/2015) <br /> '[a <br />