1801 BROADWAY DOMINOS 2025-03-25

,11 E • MECHANICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES EVERETT SUBMITTAL INSTRUCTIONS:Drop off hard copy paper application&plan to 3200 Cedar Street 2nd Floor Intake Drop Box. WASHINGTON CONTACT INFORMATION:(P)425.257.8810 I(E)everetteps@everettwa.gov I(W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET JRO/ are),"ci y PARCEL#: CRY /i R.`.It STATE W t ZIP 9t SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION: TENANT/BUSINESS NAME(if non-residential): 66 /n0 S CONTACT INFORMATION OWNER NAME: .4-t/elQc_t i'g LLC • OWNER MAILING ADDRESS: STREET 8r 2 2L / , naf Q✓� /Y _`CITY e.A,.Jt'•4L e STATE 1„/4 ZIP ' J/.s v OWNER PHONE: 2,04 _ ..3S'- Li i i OWNER EMAIL: e1 m q in , qv yia �c s C CONTRACTOR COMPANY NAME: PAS, EFR-1 'p'`IQNJ O P �L P.c.f biA%*4tS Cd.4- A-c`4,�v-.T) WA STATE CONTRACTOR LICENSE#(REQUIRED): t)4tERF EVERETT BUSINESS LICENSE#(REQUIRED): rp©SS% CONTRACTOR ADDRESS: STREET /p/r /"Y1AL/cc �1" S CITY y,Aktr3 STATE km ZIP 2,033 CONTRACTOR PHONE: 2 co i CONTRACTOR EMAIL: / 7,,9,,,,E R-e vr, ifi.ee• PRIMARY CONTACT: ❑OWNER PitiC.ONTRACTOR ❑OTHER(Please Specify) 7 CO TACT NAME: �1 L CONTACT PHONE: S-(�3 Sj o - 6,97 1---)En s l eL7 CONTACT EMAIL: .4an4 5 a J�®�- , t MECHANICAL PERMIT INFORMATION Lod k LI VALUATION OF WORK:$ 20642,O ASSOCIATED PERMIT#(if applicable): l32 j ®,f`- Oi4/' (Valuation shall include the prevailing fair market value of all labor,materials,and equipment needed to complete the work,whether actually paid or not.) BUILDING TYPE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: commercial ❑Accessory Structure DESCRIPTION OF WORK, ec j, j Ganl ? N co �to c J ' "/ /`1 .1 w -//��i '� !"6ac&.< MECHANICAL PERMIT FIXTURE COUNT (SCOPE OF WORK) Fixture Fixture Count List of Fixtures Count List of Fixtures (Qty) (Qty) NC 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.) 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 I*** Other(List Type): Exhaust Hood Type II*** Other(List Type): Fumace(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 II 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.T.: = .of a permit only authorizes approved work and no deviations therefrom.Deviations must first be authorized in writing from the Building Official before bein. -. orized under:ny c ,,r'stance.I am the owner,or I am authorized by the owner of this property to perform the work for which application is made, and I comply with the S. -Contractors La 18. — and 296.200A WAC. City of Everett Official Use Only ` PERMIT# t \\^ -Oz9 Owner/Authorized Agent Signature Date (Revised 2/8/2021) /Z