10821 19TH AVE SE PNW PHYSICAL THERAPY 2019-07-25

4rETT PERMIT APPLICATIOjn BUILDIN( IIECHANICAL/ PLUMBING /SIG�RINKLER/ DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits (Blue or Black Ink Only Please) 1r r': - ; PROD C =SITE INFORMATION PROJECT SITE ADDRESS:10821 i Avenue j 1 � 1 0 -- PROPERTY TAX#:00574700200109 LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT.INFORMATION OWNER NAME: Crow Walter A Testamentary Trust TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET 10500 NE 8TH ST STE 1900 clTr BELLEVUE 3TATE WA zip 98004 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME:Mechanical&Control Services CONTRACTOR ADDRESS: STREET 6426 18th St. E CITY Fife STATE WA ZIP 98406 CONTRACTOR PHONE:253-926-9777 CONTRACTOR EMAIL:johnm@groupmcs.com CONTRACTOR LICENSE#(REQUIRED):MECHACS962BT CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 045942 PRIMARY CONTACT: ❑OWNER D CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: • CONTACT PHONE:253-831-4446 John Merrill CONTACT EMAIL:johnm@groupmcs.com BUILDING INFORMATION, Existing Use of Building:Commercial Contract Price of Work:$15,000.00 Proposed Use of Building:Commercial Heat Source: ❑Gas DElectric ❑Other__ BUILDING USE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑✓Commercial ❑Accessory Structure Type of Project: ❑New ❑Addition ❑Remodel El Repair ❑✓T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: Install new exhaust fan to serve bathroom. Install new ductwork&GRD's to serve suites 101 & 102. ASSOCIATED BUILDING PERMIT#(if applicable): )tC6M— ©(fl MECHANICAL PERMIT.APPLICATION PLUMBING PERMIT APPLICATION;, Fixture Fixture Fixture Fixture Count List of Fixtures Count List of Fixtures Count List of Fixtures Count List of Fixtures NC—Air Handling Units Gas Piping Backflow Preventer(Inside Bldg) Shower,Tub,or Combo Boiler Gas Range Clothes Washer Sink-Commercial(3-comp,prep,floor) Clothes Dryer Heat Pump&Ductless Dishwasher Sink-Residential(kitchen,bath,bar) 2 Duct System(Remodel) Refrigeration Drinking Fountain _Sink-Utility,laundry,mop i Exhaust Fans(Residential) Commercial Ventilation Floor Drain Toilet Exhaust Hood(Type I) (Not Heat/AC system) Hose Bibb Urinal Exhaust Hood(Type II) ,Water Heater Interceptor-Grease Waste/Water Piping Repair Exhaust Hood(Residential) Wood Stove Interceptor-Sand/Oil Water Service(behind meter) Forced Air Systems -Other: Medical Gas Water Valves or Fixtures Gas Fireplace/Insert/Log Roof Drains Water Heater SPRINKLER I SUPPRESSION SYSTEM ' Sewage Ejector or Sump Pump Other: Water Suppression System No.of Heads Chemical Suppression System I No.of Heads 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 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 Building Official befo,•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, and I comply with t-'State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only , /f r/j PERMIT# \q l�� DLI L �/+/! �Sj Y/1'li ,,, Owner/Authorized Agent Signature . Date (Revised 10/10/2018) /Z.