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6920 SEAWAY BLVD 2023-06-23
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6920 SEAWAY BLVD 2023-06-23
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Last modified
6/23/2023 8:28:45 AM
Creation date
6/23/2023 8:27:51 AM
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Address Document
Street Name
SEAWAY BLVD
Street Number
6920
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• <br /> mei <br /> ME•ANICAL PERMIT APPLIC*ON <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)everetteps@everettwa.gov I(W)everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: STREET 64:120 NiS a PARCEL#: <br /> CITY latterl.C. STATE 4i , ZIP 18=15 <br /> SUITE/UNIT#: FLOOR#: 2,'tztz ADDITIONAL LOCATION INFORMATION: <br /> TENANT/BUSINESS NAME(if non-residential): 1l <br /> CONTACT INFORMATION OWNER NAME: C,P.tMw - St e . ElMlb <br /> OWNER MAILING ADDRESS: STREET '� �' ' �� ,ax > !!!! <br /> CITY +' -.. STATE %NUS*, ZIP I=Vel'3 J <br /> OWNER PHONE: arri$ •43=0 ' OWNER EMAIL:c it+ecia_c y1 p_ csA . Cewti <br /> CONTRACTOR COMPANY NAME: lalfZerrin \4 f • \%�_ <br /> • <br /> WA STATE CONTRACTOR LICENSE#(REQUIRED): ItiCtft.MotALCITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 29‘;'"7 <br /> CONTRACTOR ADDRESS: STREET Cfrp0 delkilentbk. ger <br /> CITY eq1E5allErr STATE WAN, ZIP "dI�w tr:5 <br /> CONTRACTOR PHONE: . , CONTRACTOR EMAIL: k• colit <br /> PRIMARY CONTACT: ❑OWNER %CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 4n5. 2,t calla1� c3Fe <br /> L,D. W 1..... CONTACT EMAIL: r.,,,N,A. j cr mi li • <br /> •C .i. <br /> MElt CHANICAL PERMIT INFORMATION <br /> VALUATION OF WORK:$ „ ASSOCIATED PERMIT#(if applicable): <br /> (Valuation shall include the prevailing fair market value of all abor,materials,and equipment needed to complete the work,whether actually paid or not) <br /> BUILDING TYPE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: Xommercial ❑Accessory Structure <br /> DESCRIPTION OF WORK: <br /> tee6vs.u.Alw <br /> dJ op Ham -• va.Y MA . - .CLI1 '"�? 9ak.. eeetae56 <br /> MECHANICAL PERMIT FIXTURE COUNT (SCOPE OF WORK) <br /> • <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)** Heat Pump Ductless(attach plan with location of outdoor unit) <br /> Clothes Dryer Exhaust Hydronic Piping i \ <br /> Duct System(additions,alterations) S Unit heater(commercial use) mOL •Is?...\-�A.k Sii.g‘o'\, --tac ''r c\ <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.•l 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 /> rr�� City of Everett Officialal�UseUs} Only <br /> { ` VI ' � PET ^ try <br /> V <br /> wn Authorized Agent Sign ture Date (Revised 2/8/2021) <br />
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