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477 PERMIT APPLICATIG:: <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 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:830 80TH ST SW STE 100 PROPERTY TAX#:28041200305300 <br /> LEGAL for new construction. Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: COVEWOOD MANOR LLC TENANT BUSINESS NAME(Commercial): RENU MEDICAL INC <br /> OWNER MAILING ADDRESS: STREET830 80TH ST SW STE 100 <br /> ciTn EVERETT STATE WA ZIP 98203 <br /> OWNER PHONE: 425-353-1110 OWNER EMAIL:randy@renumedical.com <br /> CONTRACTOR NAME:GS Heating &Cooling LLC <br /> CONTRACTOR ADDRESS: STREET 3409 EVERETT AVE <br /> cin, EVERETT STATE WA ZIP 98201 <br /> CONTRACTOR PHONE:425-610-4257 CONTRACTOR EMAIL:JONATHAN@GSHEATING.COM <br /> CONTRACTOR LICENSE#(REQUIRED):GSHEAHC821 QR CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 19685 <br /> PRIMARY CONTACT: ❑OWNER 17 CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:425-309-6507 <br /> JONATHAN D. FARRELL CONTACT EMAIL:JONATHAN@GSHEATING.COM <br /> BUILDING INFORMATION <br /> Existing Use of Building:OFFICE/WAREHOUSE Contract Price of Work:$$23,404.00 <br /> Proposed Use of Building: Heat Source: DGas !]Electric DOther <br /> BUILDING USE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑✓Commercial EAccessory Structure <br /> Type of Project: ❑New ❑Addition ❑Remodel ❑Repair [IT.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: Installation of two duct less heat pump to replace electric furnace in workspace <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Fixture Figure Fixture Fixture <br /> Count List of Fixtures coupe List of Fixtures Count List of Fixtures Count List of Fixtures <br /> 2 A/C-Air Handling Units Gas Piping Backflow Preventer(Inside Bldg) Shower,Tub,or Combo <br /> Boiler Gas Range Clothes Washer Sink-Commercial(3-comp,prep,floor) <br /> Clothes Dryer 2 Heat Pump&Ductless Dishwasher Sink-Residential(kitchen,bath,bar) <br /> Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility, laundry,mop <br /> Exhaust Fans(Residential) Commercial Ventilator Floor Drain Toilet <br /> Exhaust Hood(Type I) (Not Heat/AC system) Hose Bibb Urinal <br /> Exhaust Hood(Type II) Water Heater Interceptor-Grease Waste/Water Piping Repair <br /> Exhaust Hood(Residential) Wood Stove Interceptor-Sand/Oil Water Service(behind meter) <br /> Forced Air Systems Other: Medical Gas Water Valves or Fixtures <br /> Gas Fireplace/InserULog Roof Drains Water Heater <br /> SPRINKLER I SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other: <br /> Water Suppression System No.of Heads <br /> Chemical Suppression System 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 /> PERMIT#\/\(\ \oi <br /> 0.1 <br /> /Owner/Authorized Agent Signature Date (Revised 10/10/2018) - <br /> Z I <br />