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MECF" JICAL PERMIT APPLICAT' N <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 /> WASHINCaTON CONTACT INFORMATION: (P)425-257-8810 I (E)PermitServices@everettwa.gov (W)everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: STREET 2405 State St PARCEL#: 00515653601300 <br /> ar' Everett STATE WA ZIP 98201 <br /> SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION: <br /> TENANT/BUSINESS NAME(if non-residential): <br /> CONTACT INFORMATION <br /> OWNER NAME: Robert & Joan Wyatt <br /> OWNER MAILING ADDRESS: STREET 2405 State St <br /> CITY Everett STATE WA zip 98201 <br /> OWNER PHONE:425-879-7698 OWNER EMAIL:jesuszone@live.com <br /> CONTRACTOR COMPANY NAME:TBD .5\t vel <br /> WA STATE CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): <br /> CONTRACTOR ADDRESS: STREET <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> PRIMARY CONTACT: Li OWNER ❑CONTRACTOR A OTHER(Please Specify) Applicant/Project Manager <br /> CONTACT NAME:S+leVe Hall CONTACT PHONE:360-961-3638 <br /> CONTACT EMAIL:steve©rp-partners.com <br /> MECHANICAL PERMIT INFORMATION <br /> VALUATION OF WORK:$12,000 ASSOCIATED PERMIT#(if applicable):REVI 121-022 <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 /> Add DADU and garage <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.) Heat Pump(attach plan with location of outdoor unit) <br /> Compressors/Generators(building permit may be required) ** 2 Heat Pump Ductless(attach plan with location of outdoor unit) <br /> i Clothes Dryer Exhaust Hydronic Piping <br /> Duct System(additions,alterations) Unit heater(commercial use) <br /> 2 Exhaust Fan(residential or commercial use) i Water Heater(gas or electric) <br /> t 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 /> p Digitally signed by Steve Hall PERMIT# <br /> Steve Hall I I Date:2022.09.20 09:20:16-07'00' 9/20/22 h1 7 g <br /> Owner/Authorized Agent Signature Date (Revised 4/21/2022) <br />