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IIIIIIIIIII. <br />EVERETT <br />WASHINGTON <br />MECHANICAL PERMIT APPLIC • ECON <br />CITY OF EVERETT PERMIT SERVICES <br />SUBMITTAL INSTRUCTIONS: Drop off hard copy paper application & plan to 3200 Cedar Street 2nd Floor Intake Drop Box. <br />CONTACT INFORMATION: (P) 425.257.8810 1 (E) everetteps@everettwa.gov I (W) everettwa.gov/permits <br />(Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br />PROJECT SITE ADDRESS: STREET3 -7 I <br />2 t ' PARCEL #: <br />CITY STATE ZIP <br />SUITE/UNIT #: FLOOR M ADDITIONAL LOCATION INFORMATION: keX_,w;-t Z S <br />TENANT/BUSINESS NAME (if non-residential): �i / elvo, ✓- Z <br />CONTACT INFORMATION <br />OWNER NAME: / <br />OWNER MAILING ADDRESS: STREET <br />CITY STATE ZIP <br />OWNER PHONE: <br />OWNER MAIL: 4-koo �.U� cc/Z, ��✓ <br />CONTRACTOR COMPANY NAME: _ <br />WA STATE CONTRACTOR LICENSE #(REQUIRED): M L V RETT BUSINESS LICENSE #(REQUIRED): 3 <br />CONTRACTOR ADDRESS: STREET Z <br />CITY STATE ZIP o Z <br />CONTRACTOR PHONE: <br />CONTRACTOR EMAIL: <br />PRIMARY CONTACT: WNER ❑ CONTRACTOR ❑ OTHER (Please Specify) <br />CONTACT NAME: SWki-,e- <br />��/t GtC¢7�dc� jns>cr <br />CONTACT PHONE: -C— <br />CONTACTEMAIL: <br />MECHANICAL PERMIT INFORMATION <br />VALUATION OF WORK: $ -0'0 1019eg , n 0 ASSOCIATED PERMIT # (if applicable): <br />(Valuation shall include the prevailing fair marke 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-Famil - # Units: ommercial�ccessory Structure <br />DESCRIPTION OF WORK: S�=Zy� b�,�t l may- Z_ $I <br />MECHANICAL PERMIT FIXTURE <br />COUNT (SCOPE OF WORK) <br />Fixture <br />Count <br />Mill) <br />List of Fixtures <br />Fixture <br />Count <br />(Qty) <br />List of Fixtures <br />A/C Unit (attach plan with location of outdoor unit) <br />Gas Piping - List # of outlets in fixture count <br />Z <br />Air Handling Unit ** <br />Gas Appliance ** <br />Boiler (most require backflow prevention) <br />Gas Fireplace, Insert, and/or Log (* for commercial bldgs) <br />Commercial Refrigeration (walk-in coolers, VRF, VRV, etc.) <br />I Gas - Other (List Type): <br />Commercial Ventilation (corridors, stairwell, pressurization, etc.) <br />Heat Pump (attach plan with location of outdoor unit) <br />Compressors/Generators (building permit may be required) <br />Heat Pump Ductless (attach plan with location of outdoor unit) <br />Clothes Dryer Exhaust <br />Hydronic Piping <br />Duct System (additions, alterations) <br />Unit heater (commercial use) <br />Exhaust Fan (residential or commercial use) <br />Water Heater (gas or electric) <br />Exhaust Hood (residential over stove) <br />Wood/Pellet Stove or Insert <br />Exhaust Hood Type I *** <br />Other (List Type): <br />Exhaust Hood Type II <br />Other (List Type): <br />Furnace (residential) <br />Other (List Type): <br />91r For commercial gas fireplaces, please attach plans and manufacturer's installation manual. <br />** Under Description of Work, please include Type of Equipment, model Vs, 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. 1 am the owner, or 1 am authorized by the owner of this property to perform the work for which application is made, <br />and 1 comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />City of Everett Official Use Only <br />PERMIT # � <br />Z2 <br />(Revised 2/8/2021) <br />�l2- <br />