1615 75TH ST SW PACE 2022-07-14 - Laserfiche WebLink

MECHANICAL PERMIT APPLICATION 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 Ink Only Please) PROJECT'SITE INFORMATION PROJECT SITE ADDRESS: STREET 1615 75th St SW PARCEL#: 28041100101100 CITY Everett STATE WA ZIP 98203 SUITE/. IT#: 220 FLOOR#: ADDITIONAL LOCATION INFORMATION: TENAN = - - - NAME(if non-residential):PACE CONTACT INFORMATION OWNER NAME: Providence Health and Services OWNER MAILING ADDRESS: STREET 1801 Lind Ave SW CITY Renton STATE WA ZIP 98037 OWNER PHONE:4255253355 OWNER EMAIL: CONTRACTOR COMPANY NAME:Hermanson Company WA STATE CONTRACTOR LICENSE#(REQUIRED):HERMACL005BJ CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 37262 CONTRACTOR ADDRESS: STREET 1221 2nd Ave N cry Kent STATE WA ZIP 98032 CONTRACTOR PHONE:2066386961 CONTRACTOR EMAIL:kwilliams@hermanson.com PRIMARY CONTACT: ❑OWNER ❑✓ CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:2066386961 Kennedy Williams CONTACT EMAIL:kwilliams@hermanson.com MECHANICAL. PERMIT INFORMATION . VALUATION OF WORK: $14,625.00 ASSOCIATED PERMIT#(if applicable):M-2 056 2 1 r ot (Valuation shall include the prevailing fair market value of all labor,materials,and equipment needed to complete the work,whether actual) aid or not.) 9 BUILDING TYPE: ❑SFR ❑Townhouse ❑Duplex EADU EMulti-Family-#Units: ❑✓Commercial ❑Accessory Structure DESCRIPTION OF WORK: Modifications of the existing duct system to accommodate the new wall layout,clothes dryer exhaust,exhaust fans and residential hood. MECHANICAI.`PERMIT FIXTURE COUNT (SCOPE OF WORK) Fixture Fixture Count List of Fixtures Count List of Fixtures (Qty) (Qty) 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(b ding permit may be required)** Heat Pump Ductless(attach plan with location of outdoor unit) Clothes Dryer Exhaust Hydronic Piping ( + Duct System(additions,alterations) Unit heater(commercial use) (.2 Exhaust Fano(residentialss l commercialuse) Water Heaterlletve or Insert � Exhaust Hood(residential over stove) Wood/Pellet Stove or Insert Exhaust Hood Type I *** Other(List Type): itE EOVE Exhaust Hood Type II *** Other(List Type): Furnace(residential) Other(List Type): MAP 1 2 2 72 LI * For commercial gas fireplaces,please attach plans and manufacturer's installation manual. .-1.r_/ ** Under Description of Work,please include Type of Equipment,model#'s,ad detailed description of work,and th yt �ryz�hEGvEdR{ET�u1 *** Type I hood and Type II hoods shall be on a stand alone Mechanical Permit application and requires plan review. 1ft 1 It e t V I dot ments as described in the associated Checklists online at everettwa.gov/permits under the Checklists&Handouts tab. ff TT II 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.lam the owner,or I am authorized ky the o er of is erty toy',form the work for which application is made, and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC,) �\ u�a' << City of Everett Official Use Only PE Nil\ 1 L#. ^ — OS� Kennedy Williams "' °"`°"'"""-"u"°"""""�'^"'°�'" 3/22/2022 Owner/Authorized Agent Signature Date (Revised 2/8/2021) )