10318 EVERGREEN WAY WOODS COFFEE 2023-03-30

I� EVERETT WASHINGTON MECHANICAL PERMIT APPLICATION 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 10318 Evergreen Way PARCEL #: 0053520000100 CITY Everett STATE WA ZIP 98204 SUITEIUNIT #: FLOOR #: ADDITIONAL LOCATION INFORMATION: TENANT/BUSINESS NAME (if non-residential): WOODS COFFEE CONTACT INFORMATION OWNER NAME: TAYLOR HERMAN - WOODS COFFEE OWNER MAILING ADDRESS: STREET 191 18TH ST CITY LYNDEN STATE WA ZIP 98264 OWNER PHONE:360.393.7553 OWNER EMAIL: TAYLORH@WOODSCOFFEE.COM CONTRACTOR COMPANY NAME: CONTRACT HAS NOT BE AWARDED WA STATE CONTRACTOR LICENSE #(REQUIRED): CITY OF EVERETT BUSINESS LICENSE #(REQUIRED): CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: PRIMARY CONTACT: ❑e OWNER ❑ CONTRACTOR ❑ OTHER (Please Specify) CONTACT NAME: TAYLOR H E RMAN CONTACT PHONE:360.393.7553 CONTACT EMAIL:TAYLORH@WOODSCOFFEE.COM MECHANICAL PERMIT INFORMATION VALUATION OF WORK: $15,000 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 ❑Duplex ❑ADU ❑Multi -Family - # Units: ❑✓ Commercial ❑Accessory Structure DESCRIPTION OF WORK: DRYER VENTING, DUCTLESS HVAC, EXHAUST FAN PER ENGINEERED PLANS MECHANICAL PERMIT FIXTURE COUNT (SCOPE OF WORK) Fixture Count (Qty) List of Fixtures Fixture Count MW List of Fixtures A/C Unit (attach plan With location of outdoor unit) Gas Piping - List # of outlets in fixture count Air Handling Unit atrttr Gas Appliance ** Boiler (most require backflow prevention) ** Gas Fireplace, Insert, and/or Log (tk for commercial bldgs) Commercial Refrigeration (Walk-in coolers, VRF, VRV, etc.) Gas - Other (List Type): ak* 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) Unit heater (commercial use) Exhaust Fan (residential or commercial use) Water Heater (gas at electricl Wood/Pellet Stove or Insert Exhaust Hood (residential over stove) Exhaust Hood Type 11F11tilr Other (List Type): _ Exhaust Hood Type II *+k* Other (List Type): _ Furnace (residential) Other (List Type): _ itr For commercial gas fireplaces, please attach plans and manufacturer's installation manual. �Inik 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 I I 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 r,eing 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 the4tate Contractors Law 18.27 RCW and 296.200A WAC. Agent jl///Z.l Date City of Everett Official Use Only FPERMIT # (Revised 21812021)