2007 CEDAR ST 2023-04-10 - Laserfiche WebLink

MitHANICAL PERMIT APPLI TION 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 200+etarC) � PARCEL#:0066 101=00 CITY Ev.eire_ STATE baq ZIP 'X ZO r SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION: TENANT/BUSINESS NAME(if non-residential): CONTACT INFORMATION OWNER NAME: (')jy1r, OfrL 1 OWNER MAILING ADDRESS: STREET 2 1- c 54-1e2-' CITY Eve STATE A ZIP /rz O 1 OWNER PHONE: 0017.E 25tf-11616 OWNER EMAIL: ryyrit1 ('i ( I/1 O� ✓,�Ia 1- co./R CONTRACTOR COMPANY NAME: r.L-jGj 5 COnch' C- on Go. 11 C- WA STATE CONTRACTOR LICENSE#(REQUIRED):l.Jl�V)an ce,CMPACITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 064755.3 CONTRACTOR ADDRESS: STREET 5,30 3 ,� rd � Ave, CITY /i/A Q�g STATE w ZIP / W LI Zr7 CONTRACTOR PHONE: 2�WWq Igq CONTRACTOR EMAIL: CA)eti cO('J r ScoviSkuction4, PRIMARY CONTACT: WNER T1ONTRACTOR KTHER(Please Specify) 0ww '5 'W CONTACT NAME: I CONTACT PHONE: ('125) 220 9r9 f iC.O'��'� CONTACT EMAIL: �� cotrir@aloe/ trit,A4 MECHANICAL PERMIT INFORMATION VALUATION OF WORK:$ 6000 ASSOCIATED PERMIT#(if applicable): (Valuation shall include the revailin fair market value of all labor,materials,and equipment needed to complete the work,whether actually aid or not.) BUILDING TYPE: ;FR ownhouse luplex telin-5k ,DU Multi-Family-#Units: 1ommercial riccessory Structure DESCRIPTION 0 RK: i ' .b-t ear• MECHANICAL PERMIT FIXTURE COUNT (SCOPE OF WORK) Fixture Fixture Count List of Fixtures Count List of Fixtures (Qty) (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.) 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) j 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 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# 6 - L/ . 2? m2,i06 -Olt Ow /Authorized t Signature Date (Revised 2/8/2021)