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4677:1-7,0 PERMIT APPLICATION <br /> BUILDIN@ECHANICAL/ PLUMBING /SIGN • =RINKLER/ DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 I 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: 2615 West Casino Road-Ste 5F PROPERTY TAX#: 28041400201600 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> e. <br /> tONTACtA INFORMATION <br /> OWNER NAME: S N Investment Properties, LLC TENANT NAME(If Commercial): Andpak <br /> OWNER MAILING ADDRESS: STREET 1121 SW Salmon St. <br /> CITY Portland STATE Oregon ZIP 97205 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: United Systems Mechanical, LLC <br /> CONTRACTOR ADDRESS: STREET 1400 Airport Way South,Ste 202 <br /> c T., Seattle STATE WA ZIP 98134 <br /> CONTRACTOR PHONE: (206)933-6036/(206) 604-1711 CONTRACTOR EMAIL: tom@us-mechanical.com <br /> CONTRACTOR LICENSE#(REQUIRED): UNITESM962QA CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 054416 <br /> PRIMARY CONTACT: 0 OWNER pr CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: (206) 604-1711 <br /> Tom Reddy CONTACT EMAIL: tom@us-mechanical.com <br /> . <br /> , ,,: <br /> BUILDING,;PERMIT APPLICATION . „,, a <br /> Existing Use of Building: t g-s cm/ 1,4.v4,40e, Contract Price of Work:$ r c(IC _.-- <br /> Proposed Use of Building: J41^41.- Heat Source: ❑Gas ❑Electric ❑Other I•1/1 <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: LgCommercial ❑Industrial <br /> Type of Project: ❑New ❑Addition ❑Remodel ❑Repair [MT.!. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: ititiAOnt. (t) c/1o0 {-01i eKl t c.y,S F ' 4y i41.e9 vi z.e d CC 4 vheaev Otct,cf�n1 <br /> I <br /> £ P any f9I5 , <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 /> 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 /> 1 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 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 /> ill't4 (0 I j I $ PERMIT#144 ( 6 I o U(3 <br /> Owner/Aut prized.Agent Signature Date (Revised 9/23/2016) <br />