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3726 COLBY AVE 2023-10-24
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3726 COLBY AVE 2023-10-24
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Last modified
10/24/2023 9:05:49 AM
Creation date
4/6/2023 10:22:41 AM
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Address Document
Street Name
COLBY AVE
Street Number
3726
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MEcANICAL PERMIT APPLICAJN <br /> CITY OF EVERETT PERMIT SERVICES <br /> EVERETT SUBMITTAL INSTRUCTIONS:Drop off hard copy paper application&plan to 3200 Cedar Street 2nd Floor Intake Drop Box. <br /> WASHINGTON CONTACT INFORMATION: (P)425-257-8810((E)PermitServices©everettwa.gov((W)everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: STREET 3X8 Colby Ave (3724.61,y4.)4} PARCEL#: 00451402401800 <br /> CITY Everett STATE WA ZIP 98201 <br /> SUITE/UNIT#: 1 FLOOR#: 1 ADDITIONAL LOCATION INFORMATION: <br /> TENANT/BUSINESS NAME(it non-residential): The Everett Clinic- MOHS Surgery <br /> CONTACT INFORMATION <br /> OWNER NAME: MOHS Laser and Skin Surgery <br /> OWNER MAILING ADDRESS: STREET 3726 Colby Ave <br /> cITY Everett STATE WA ZIP 98201 <br /> OWNER PHONE:425.210.8175 OWNER EMAIL:ken_mietzner@uhg.com <br /> CONTRACTOR COMPANY NAME:Team Mechanical Inc. <br /> WA STATE CONTRACTOR LICENSE#(REQUIRED):TEAMMI*030J8 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 036516 <br /> CONTRACTOR ADDRESS: STREET PO BOX 789 <br /> CITY Monroe SlATE WA LIP 98272 <br /> CONTRACTOR PHONE:360-805-1835 CONTRACTOR EMAIL:Teammechanical@aol.com <br /> PRIMARY CONTACT: ❑OWNER ❑✓ CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME:Jeff Saeth e r CONTACT PHONE:360-805-1835 <br /> CONTACT EMAIL:Teammechanical@aol.com <br /> MECHANICAL PERMIT INFORMATION <br /> VALUATION OF WORK: $102,500.00 ASSOCIATED PERMIT#(it applicable):NA <br /> (Valuation shall include the prevailing fair market value of all labor,materials,and equipment needed to complete the work,whether actually paid or not.) <br /> BUILDING TYPE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑✓Commercial ❑Accessory Structure <br /> DESCRIPTION OF WORK: <br /> Replacement of 3 split-system HVAC units <br /> MECHANICAL PERMIT FIXTURE COUNT (SCOPE OF WORK) <br /> Fixture Fixture <br /> Count List of Fixtures Count List of Fixtures <br /> (QtY) (QtY) <br /> A/C Unit(attach plan with location of outdoor unit) Gas Piping-List#of outlets in fixture count <br /> Air Handling Unit** Gas Appliance** <br /> Boiler(most require backflow prevention)** Gas Fireplace,Insert,and/or Log(*for commercial bldgs) <br /> Commercial Refrigeration(Walk-in coolers,VRF.VRV.etc.) Gas-Other(List Type): ** <br /> Commercial Ventilation(corridors,stairwell,pressurization,etc.) 3 Heat Pump(attach plan with location of outdoor unit) <br /> Compressors/Generators(building permit may be required)** Heat Pump Ductless(attach plan with location of outdoor unit) <br /> Clothes Dryer Exhaust _ _ Hydronic Piping <br /> 3 Duct System(additions,alterations) Unit heater(commercial use) <br /> Exhaust Fan(residential or commercial use) Water Heater(gas or electric) <br /> Exhaust Hood(residential over stove) Wood/Pellet Stove or Insert <br /> Exhaust Hood Type I*** Other(List Type): <br /> Exhaust Hood Type II*** Other(List Type): <br /> Furnace(residential) Other(List Type). <br /> * For commercial gas fireplaces,please attach plans and manufacturer's installation manual. <br /> ** Under Description of Work,please include Type of Equipment,model#'s,ad detailed description of work,and the location of the equipment. <br /> *** 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 <br /> described in the associated Checklists online at everettwa.gov/permits under the Checklists&Handouts tab. <br /> 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 <br /> 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 <br /> 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, <br /> and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> Zgz1_/ AAjZo ;- oog <br /> Owner/ o d A t ignature Dat (Revised 4/21/2022) <br />
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