6500 EVERGREEN WAY CENTRAL BODY WORKS 2023-06-13

• MEM 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. CONTACT INFORMATION:(P)425.257.8810 (E)everetteps©everettwa.gov (W)everettwa.gov/ ermits "Zo er) WASHINGTON (Blue or Black Ink Only Please) PROJECT SITE INFORMATION .-c, PROJECT SITE ADDRESS: STREET I ve,v U /PARCEL#: )C.)1 Ce) CO;Ct 1",r cm, C\fere 4-t- STATE (,4,414 ZIP SUITEIUNIT#: 6 FLOOR#: ADDITIONAL LOCATION INFORMATION: TENANTJBUSINESS NAME(if non-residential): C.Q,,-\ k1/4 CONTACT INFORMATION OWNER NAME: OWNER MAILING ADDRESS: STREET /3/C3 'Tq4,- (.4--e.5- CITY -t/f eVek STATF Lit,a ZIP (7? ) OWNER PHONE: (47/Z si - OWNER EMAIL: Irv) IA4)6 G,...,ecavykcco Ccvs•-• CONTRACTOR COMPANY NAME:C t (AL)rt Sk-ck 3CLIAN.s..");-‘) WA STATE CONTRACTOR LICENSE#(REQUIRE L) S105SS5 CITY OF EVERETT BUSINESS UCENSE#(REQUIRED): /062 CONTRACTOR ADDRESS: STREET Z07 1-(C-h{ / (-+ STATE kj-) ZP cfc, 2:7 1 CONTRACTOR PHONE2,S1—ZSS^ 374(a. CONTRACTOR EMAIL:C. aAsTruLrc‘oiLY-0, C-fbc\--Ntizi- PRIMARY CONTACT: ,Er6WNER D CONTRACTOR El OTHER(Please Specify) CONTACT NAME: CONTACT PHONE6'-25 (o(78.2-- Ilf\k AACne.f\3 CONTACT EMAIL: , eefil-cek 1,7xxLLay, MECHANICAL PERMIT INFORMATION VALUATION OF WORK: $ /49.5";c3,2.(n r7(c, ASSOCIATED PERMIT#(if aeplicable),: (Valuation shall elude the prevailing fair market value of at labor,materials,and equipment needed to complete the work,whether actually paid or not.) BUILDING TYPE: OSFR t:Townhouse EDuplex DADU DMulti-Family-4 Units:_ "Ozgammercial [(Accessory Structure DESCRIPTION OF WORK:' ;NS.I-PAN L‘STE. Qfp,m.r C bt c‘1%4 yk cycs 15-cf- 27/24 0? „ . MECHANICAL PERMIT FIXTURE COUNT(SCOPE OF WORK) Fixture Fixture Count List of Fixtures Count List of Fixtures (OW (Qty) A/C 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.i 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) Unit heater(commercial use) Exhaust Fan(residential or commercial use) er Heater(gas or electric) Exhaust Hood(residential over stove) ood/Pellet Stove or Insert Exhaust Hood Type I*** Other(List Type): lii:11N1-,-; EKOCSNIA 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/perrnits 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 fedelsg,state,and focal law.The granting of a permit only authorizes appmved work and no deviations therefrom.Deviations must first be authorized in writing from the BuildingOfficial btfore being authorized under any circumstance.Fern 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 he State Contractors Law 16,27 RCW and 296,200A WAC. City of Everett Official Use Only PTAAMIT# (a 7,- ( Owner/AattriorizialAgent Signature Dete (Revised 2/8/2021)