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PERMIT APPLICATion <br /> BUILDING / MECHANICAL/ PLUMBING / SIGN / SPRINKLER / DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> OL (P)425-257-8810 1 FAX 425-257-8857 1 (E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJE T SITE ADDT.,SS: PROPERTY TAX#: <br /> 6623 ver reen a 00392900500501 <br /> LEGAL for new construction: Short Plat subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Union Bank TENANT NAME(If Commercial): Union Bank <br /> OWNER MAILING ADDRESS: STREET PO Box 7788 <br /> CITY Ne=ort BeachSTATE CA ZIP 92658 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME; Johansen Mechanical Inc. <br /> CONTRACTOR ADDRESS: STREET 20109 144th Ave NE <br /> CITY woodinvillSTATE WA zip 98072 <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: iv 1 johansenmech.com <br /> CONTRACTOR LICENSE#(REQUIRED): JOHANMI173PK I CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 024276 <br /> PRIMARY CONTACT: ❑OWNER Ig 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: Bank lContract Price of Work: $ 75,691 <br /> Proposed Use of Building: Same Heat Source: aGaS ERElectric ❑Other <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: MCommercial ❑Industrial <br /> Type of Project: ❑New ❑Addition ❑Remodel ❑Repair INT.1. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: <br /> Remove/replace 2 existing packaged units with 1 new 10 ton packaged heat pump/AC, install new VAV's,new <br /> ductless split unit, replace 1 exhaust fan, replace heater, grds &accessories, modify ductwork per plans <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 #of List of Fixtures #of List of Fixtures #of List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> 1 A/C—Air Handling Units I Heat Pump Toilet Backflow Preventer(Inside Bldg) <br /> Forced Air Systems 3Unit 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 I Ducting Dishwasher Roof Drains <br /> Clothes Dryer Hookups 7 Other: Clothes Washer Medical Gas <br /> Range Hood Grilles Water Heater Other: <br /> 1 Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: <br /> SPRINKLER/ SUPPRESSION SYSTEM <br /> Number of Heads <br /> ACKNOWLEDGEMENT.'/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./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 /> Owner/Aut ized A igna ure Date (Revised 10/12/2015) <br /> Z <br />