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LI MEWANICAL PERMIT APPLICoION <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 I (E)PermitServices@everettwa.gov I (W)everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: STREET 2825 COLBY AVE PARCEL#: 00439166700801 <br /> ciT" EVERETT STATE WA ZIP 98201 <br /> SUITE/UNIT#: FLOOR#: 1 ADDITIONAL LOCATION INFORMATION: <br /> TENANT/BUSINESS NAME (if non-residential):HERITAGE BANK <br /> CONTACT INFORMATION <br /> OWNER NAME: SKOTDAL BROTHERS LLC <br /> OWNER MAILING ADDRESS: STREET 2910 COLBY <br /> crry EVERETT STATE WA zp 98206 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR COMPANY NAME:MACDONALD MILLER FACILITY SOLUTIONS <br /> WA STATE CONTRACTOR LICENSE#(REQUIRED):MACDOFS808OS CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 040665 <br /> CONTRACTOR ADDRESS: STREET 17930 INTERNATIONAL BLVD, SUITE 120 <br /> ciTv SEATAC STATE WA ziP 98188 <br /> CONTRACTOR PHONE:206-763-9400 CONTRACTOR EMAIL:Permits@macmiller.com <br /> PRIMARY CONTACT: ❑ OWNER ❑✓ CONTRACTOR ❑ OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:206-867-4133 <br /> AMANDA MOORE CONTACT EMAIL:permits@macmiller.com <br /> MECHANICAL PERMIT INFORMATION <br /> VALUATION OF WORK: $40,000 ASSOCIATED PERMIT#(if applicable):B2207-053 <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 PIADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure <br /> DESCRIPTION OF WORK: DEMO EXISTING DIFFUSERS, GRILLES, AND VAV BOX. INSTALL NEW DIFFUSERS, GRILLES, AND <br /> ASSOCIATED DUCTWORK PER NEW FLOOR LAYOUT. INSTALL TRANSFER EXHAUST FANS THAT WILL TIE <br /> INTO EXISTING EXHAUST SYSTEM AND NEW VAV BOX. <br /> MECHANICAL PERMIT FIXTURE COUNT (SCOPE OF WORK) <br /> Fixture I 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.) 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 /> Duct System(additions,alterations) Unit heater(commercial use) <br /> 2 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 *** 1 Other(List Type):VAV box <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 /> L!9 �'a�cC y,22.1 1.18 15 5 Seattle,0106 00' 11/18/22 V 1 '2 Z I 1 — U 1 Z <br /> Owner/Authorized Agent Signature Date (Revised 4/21/2022) <br /> /2 <br />