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

4rE.17 PERMIT APPLICATION BUILDING /MECHANICAL/ PLUMBING/SIGN J �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) PROJECT,,SITE INFORMATION PROJECT SITE ADDRESS:108).l lith Avenue S€ 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 crry BELLEVUE STATE WA Zip 98004 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME:Mechanical&Control Services CONTRACTOR ADDRESS: STREET 6426 18th St. E CITY Fife STATE WA z 98406 CONTRACTOR PHONE:253-926-9777 CONTRACTOR EMAIL:iohnm@groupmcs.com CONTRACTOR LICENSE#(REQUIRED):MECHACS962BT CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 045942 PRIMARY CONTACT: ❑OWNER 0 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:$35,000.00 Proposed Use of Building:Commercial Heat Source: ❑Gas DElectric ❑Other BUILDING USE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ✓❑Commercial DAccessory Structure Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ET.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: REPLACE (2) EXISTING SPLIT SYSTEMS. INSTALL(1) ERV SYSTEM. ASSOCIATED BUILDING PERMIT#(if applicable): 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 2 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 2 Heat Pump&Ductless Dishwasher Sink-Residential(kitchen,bath,bar) Duct System(Remodel) 2 Refrigeration Drinking Fountain Sink-Utility,laundry,mop 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 SUPPRESSION SYSTEM;, Sewage Ejector or Sump Pump Other: Water Suppression SystemNo.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 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, and I comply with the to Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use/Only PER6a k,q o ` Owne uthorize Agent Signature Date (Revised 10/10/2018)