6430 BROADWAY 2023-08-08 - Laserfiche WebLink

MECHANICAL PERMIT APPLICATION EVERETT WASHINGTON CITY OF EVERETT PERMIT SERVICES SUBMITTAL INSTRUCTIONS: Drop off hard copy paper application & plan to 3200 Cedar Street 2nd Floor Intake Drop Box. CONTACT INFORMATION: (P) 425-257-8810 1 (E) PermitServices@everettwa.gov I (W) everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 6424 Broadway Avenue PARCEL #: 75267 cITY Everett STATE WA zip 98203 SUITE/UNIT #: FLOOR #: 1 ADDITIONAL LOCATION INFORMATION: TENANT/BUSINESS NAME (if non-residential): St. Vincent de Paul's Storage Building CONTACT INFORMATION OWNER NAME: Society of Vincent dePaul Thrift Store OWNER MAILING ADDRESS: STREET 6424 Broadway CITY Everettt STATE WA ZIP 98203 OWNER PHONE: 236-466-3821 OWNER EMAIL: Inga@SVdPnsc.com CONTRACTOR COMPANY NAME: United Systems Mechanical, LLC. WA STATE CONTRACTOR LICENSE #(REQUIRED): UNITESM962QA CITY OF EVERETT BUSINESS LICENSE #(REQUIRED): 054416 CONTRACTOR ADDRESS: STREET 1400 Airport Way South CITY Seattle STATE WA ZIP 91834 CONTRACTOR PHONE. 206-510-8080 CONTRACTOR EMAIL: Peter@US-Mechanical.Com PRIMARY CONTACT: NER ✓ NTRACTOR HER (Please Specify) CONTACT NAME: Peter C rP I I Py CONTACT PHONE: 206-5510-8080 CONTACT EMAIL: Peter@US-Mechanical.com MECHANICAL PERMIT INFORMATION VALUATION OF WORK: $ 63,650 ASSOCIATED PERMIT # (if applicable): PW2210-10, B2112-004 (Valuation shall include tl ailing rket value of all materials quipm ded to complete the work, whether actu d or not.) BUILDING TYPE: R win ouse plex U Iti-Family - # Units: mmercial cessory Structure DESCRIPTION OF WORK: Three duct -less split -system HP's, refrigernat piping, condensate piping, Two DOAS/ERV systems MECHANICAL PERMIT FIXTURE COUNT (SCOPE OF WORK) Fixture Count (Qty) List of Fixtures Fixture Count (Qty) List of Fixtures 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 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 1 *** 2 Other (List Type): ERVS 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 11 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 1 am authorized by the owner of this property to perform the work for which application is made, and 1 comply with the State Contractors Law 18.27 RCW and 296.200A WAC. Owner/Authorized Agent DECEMBER 6, 2022 Date City of Everett Official Use Only PERMIT # (Revised 412112022)