1919 112TH ST SW 2021-11-08 - Laserfiche WebLink

ME1DIANICAL PERMIT APPLICakION CITY OF EVERETT PERMIT SERVICES EVERETT SUBMITTAL INSTRUCTIONS:Drop off hard copy paper application&plan to 3200 Cedar Street 2nd Floor Intake Drop Box. WASHINGTON CONTACT INFORMATION:(P)425.257.8810 I(E)everetteps@everettwa.gov I(W)everettwa.gov/permits (Blue or Black in cc Only Please) .,. P tOJECT SITE'INFORMATION PROJECT SITE ADDRESS: STREET 1919 112th St SW PARCEL#: 00537900003400 cry Everett STATE WA ZIP 98204 SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION: TENANT/BUSINESS NAME(if non-residential):Everett Center v. .CONTACT INFORMATION OWNER NAME: Nationwide Health Properties OWNER MAILING ADDRESS: STREET 18818 Teller Ave#277 CITY Irvine STATE CA ZIP 92612 OWNER PHONE: OWNER EMAIL: CONTRACTOR COMPANY NAME:Comfort Systems Northwest WA STATE CONTRACTOR LICENSE#(REQUIRED):COMFOSU842LB CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 17389 CONTRACTOR ADDRESS: STREET 18702 N Creek Pkwy,Suite 110 CITY Bothell STATE WA ZIP 98011 CONTRACTOR PHONE:425-883-9224 CONTRACTOR EMAIL:mpomada@csusanw.com PRIMARY CONTACT: ❑OWNER ❑✓ CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: Misty POmada CONTACT PHONE:425-883-9224 CONTACT EMAIL:mpomada@csusanw.com MECHANICAL PERMIT INFORMATION VALUATION OF WORK:$82350 ASSOCIATED PERMIT#(if applicable): (Valuation shall include the prevailing fair market value of all labor,materials,and equipment needed to complete the work,whether actually paid or not.) BUILDING TYPE: ❑SFR ❑Townhouse EDuplex ❑ADU ❑Multi-Family-#Units: ❑✓Commercial ❑Accessory Structure DESCRIPTION OF WORK: Replacing 5 RTUs and 3 MAUs with new. MECHANICAL PERMITiFIXTURE COUNT (SCOPE OFy WORK} Fixture Fixture Count List of Fixtures Count List of Fixtures (QtY) (QtO) 5 NC Unit(attach plan with location of outdoor unit) Gas Piping-List#of outlets in fixture count Air Handling Unit** Gas Appliance** Boiler(most require backflow prevention)** Gas Fireplace,Insert,and/or Log(*for commercial bldgs) Commercial Refrigeration(Walk-in coolers,VRF,VRV,etc.) Gas-Other(List Type): ** Commercial Ventilation(corridors,stairwell,pressurization,etc.) Heat Pump(attach plan with location of outdoor unit) Compressors/Generators(building permit may be required)** Heat Pump Ductless(attach plan with location of outdoor unit) Clothes Dryer Exhaust Hydronic Piping Duct System(additions,alterations) 3 Unit heater(commercial use) Exhaust Fan(residential or commercial use) Water Heater(gas or electric) Exhaust Hood(residential over stove) Wood/Pellet Stove or Insert Exhaust Hood Type I*** Other(List Type): Exhaust Hood Type II*** Other(List Type): Furnace(residential) Other(List Type): * For commercial gas fireplaces,please attach plans and manufacturer's installation manual. ** Under Description of Work,please include Type of Equipment,model#'s,ad detailed description of work,and the location of the equipment. *** Type I hood and Type II hoods shall be on a stand alone Mechanical Permit application and requires plan review.Please submit the required documents as described in the associated Checklists online at everettwa.gov/permits under the Checklists&Handouts tab. 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 State Contractors Law 18.27 RCW and 296.200A WAG. City of Everett Official Use Only PERMIT#M2103-041 Owner Authorized A nt tgnature V V ' Date (Revised 2M/2021)