706 32ND ST 2023-04-04 - Laserfiche WebLink

MECHANICAL PERMIT APPLICATION EVERETT WASHINGTON CITY OF EVERETT PERMIT SERVICES SUBMITTAL INSTRUCTIONS: Drop off hard copy paper application & plan to 3200 Cedar Street 2nd Floor Intake Drop Box. CONTACT INFORMATION: (P) 425.257.8810 1 (E) everetteps@everettwa.gov I (W) everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET r �Zrl PARCEL #: cnY STATE w1fZIP SUITE/UNIT #: FLOOR M ADDITIONAL LOCATION INFORMATION: TENANT/BUSINESS NAME (if non-residential): CONTACT INFORMATION OWNER NAME: I IJ j OWNER MAILING ADDRESS: STREET CITY V. STATE ZIP OWNER PHONE: OWNER EMAIL: CONTRACTOR COMPANY NAME: gi't1CC' ChYts'�G� uCt 10 WA STATE CONTRACTOR LICENSE #(REQUIRED)6 UCE CG 605j N CITY OF EVERETT BUSINESS LICENSE #(REQUIRED):62'-{ �j(p CONTRACTOR ADDRESS: STREET 8eA A ( NVQ, CITY STATE Wo' ZIP W E CONTRACTOR PHONE: ��j - Z„j — �j' CONTRACTOR EMAIL:Ckt( &t60 ter,c.ovi 5+rU d tovtiL PRIMARY CONTACT: ❑ OWNER §4 CONTRACTOR ❑ OTHER (Please Specify) CONTACT NAME: CONTACT PHONE: CONTACT EMAIL: MECHANICAL PERMIT INFORMATION 11 VALUATION OF WORK: $ Zv 00 " ° ASSOCIATED PERMIT # (if applicable): ZI 1 ZS (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 ❑Duplex OADU ❑Multi -Family - # Units: ❑Commercial ❑Accessory Structure OF DESCRIPTION WORK: NVW 40yr Pume(oUc,-LZ-ss) MECHANICAL PERMIT FIXTURE COUNT (SCOPE OF WORK) Fixture Count (Qty) List of Fixtures Fixture Count (Qty) List of Fixtures 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): *tilt Commercial Ventilation (corridors, stairwell, pressurization, etc.) Heal Pump (attach plan with location of outdoor unit) Compressors/Generators (building permit maybe 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) 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 Vs, 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 doclents 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. 1 am the owner, or I am authorized by the owner of this property to perform the work for which application is made, and 1 comply with the State Contractors Let,., 18.27 RCW and 296.200A WAC. Agent Signature l/-16-ZZ Date City of Everett Official Use Only PERMIT # M2.211- 05[e (Revised 21812021) ,« w\