3726 COLBY AVE 2023-10-24 - Laserfiche WebLink

MEcANICAL PERMIT APPLICAJN 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((E)PermitServices©everettwa.gov((W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 3X8 Colby Ave (3724.61,y4.)4} PARCEL#: 00451402401800 CITY Everett STATE WA ZIP 98201 SUITE/UNIT#: 1 FLOOR#: 1 ADDITIONAL LOCATION INFORMATION: TENANT/BUSINESS NAME(it non-residential): The Everett Clinic- MOHS Surgery CONTACT INFORMATION OWNER NAME: MOHS Laser and Skin Surgery OWNER MAILING ADDRESS: STREET 3726 Colby Ave cITY Everett STATE WA ZIP 98201 OWNER PHONE:425.210.8175 OWNER EMAIL:ken_mietzner@uhg.com CONTRACTOR COMPANY NAME:Team Mechanical Inc. WA STATE CONTRACTOR LICENSE#(REQUIRED):TEAMMI*030J8 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 036516 CONTRACTOR ADDRESS: STREET PO BOX 789 CITY Monroe SlATE WA LIP 98272 CONTRACTOR PHONE:360-805-1835 CONTRACTOR EMAIL:Teammechanical@aol.com PRIMARY CONTACT: ❑OWNER ❑✓ CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME:Jeff Saeth e r CONTACT PHONE:360-805-1835 CONTACT EMAIL:Teammechanical@aol.com MECHANICAL PERMIT INFORMATION VALUATION OF WORK: $102,500.00 ASSOCIATED PERMIT#(it applicable):NA (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: Replacement of 3 split-system HVAC units 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.) 3 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 3 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# Zgz1_/ AAjZo ;- oog Owner/ o d A t ignature Dat (Revised 4/21/2022)