11108 EVERGREEN WAY ALEM MARKET 2022-11-17

Eill ME!HANICAL 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 1 I 1 02 t� IM1 E(/fqV '�!/1 PARCELS#y: coif -- E CITY e✓eve•1- ✓ STATE k ZIP `132C2c1 SUITE/UNIT#:E FLOOR#: I ADDITIONAL LOCATION INFORMATION: TENANT/BUSINESS NAME(if non-residential): Ale v -• A,,lav -r 'cow( n CONTACT INFORMATION OWNER NAME: J(�(1'co LOQ -l-V& L L-C, p p OWNER MAILING AD ESS: STREET _??S 3 c Ln`2 �L' ✓) (} CITY , 01/„; (�'{.V), STATE ZIP Cl eZ TS-- OWNER PHONE: OWNER EMAIL: CONTRACTOR COMPANY NAME:'Pajairl I W C• ✓"S 1.--4--C WA STATE CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED):0 Leo J CONTRACTOR ADDRESS: STREET/0Z th /We- . S , ��J C '�7 p� CITY A-(,9011A STATE V� ZIP 1[!0l,! 1 CONTRACTOR PHONE: 'ZOC9 (407 L-17 IG' 1�' CONTRACTOR EMAIL: L��b✓L �'� �C�yMC[t�. Cc> -t 1 PRIMARY CONTACT: 0 OWNER CONTRACTOR 0 OTHER(Please Specify) CO TACT NAME: CONTACT PHONE:j C, L(c `7 (--(I'7 C. 6, (.�(• tCe pa,jL(V ✓✓ l CONTACT EMAIL: Lj vl baf (crfh v �vti'1i j . (c�)tn JJ MECHANICAL PERMIT INFORMATION VALUATION OF WORK:$ ?CC 0 ASSOCIATED PERMIT#(if applicable):AZ fi1 7'—©ot (Valuation shall include the prevailing fair market value of all labor,materials,and equipment needed to complete the work,whether actuallylyq paid or not.) BUILDING TYPE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ,K7Commercial DAccessory Structure DESCRIPTION OF WORK: ., vtS'}-Ct 11 ee —I hood tt-24h exhous t MECHANICAL PERMIT FIXTURE COUNT (SCOPE OF WORK) Fixture Fixture Count List of Fixtures Count List of Fixtures (Qty) (CRY) 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.) 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 I •Duct System(additions,alterations) 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 ' X ,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 WAC. City of Everett Official Use Only PERMIT# jf\. _ 0 (1 r� •••r/•T'prized Agent Signature Date (Revised 2/8/2021) /2--