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MEC"ANICAL PERMIT APPLICpTlON <br /> CITY OF EVERETT PERMIT SERVICES EVERETT c�fj� <br /> ' <br /> SUBMITTAL INSTRUCTIONS: Drop off hard copy paper application &plan to 3200 Cedar StreecZrid Igor Intake Drop Box. <br /> WASHINGTON CONTACT INFORMATION: (P)425-257-8810 1 (E)PermitServices@everettwa.gov I (W)pr rettWa.gov/permits L <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION r-VitNETT <br /> PROJECT SITE ADDRESS: STREET 2825 Colby Ave PARCEL#: 00439p66700801 v S <br /> CITY Everett STATE WA ZIP 96213 <br /> SUITE/UNIT#: FLOOR#: 5&Roof ADDITIONAL LOCATION INFORMATION: <br /> TENANT/BUSINESS NAME (if non-residential):Skotdal-Colby Center <br /> CONTACT INFORMATION <br /> OWNER NAME: SKOTDAL BROTHERS LLC <br /> OWNER MAILING ADDRESS: STREET PO BOX 5267 <br /> CITY Everett <br /> STATE WA Zip 98206 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR COMPANY NAME:MacDonald Miller Facility Solutions <br /> WA STATE CONTRACTOR LICENSE#(REQUIRED):MACDOFS8080S CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 040665 <br /> CONTRACTOR ADDRESS: STREET 17930 International Blvd., Suite 120 <br /> clTy Seatac WA 98188 <br /> STATE ZIP <br /> CONTRACTOR PHONE:206-768-4062 CONTRACTOR EMAIL:permits@ macmiller.cdm <br /> PRIMARY CONTACT: ❑ OWNER RI CONTRACTOR I_✓_I OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:206-768-4062 <br /> A m m o n e B e m b ry CONTACT EMAIL:permits@macmiller.com <br /> MECHANICAL PERMIT INFORMATION <br /> VALUATION OF WORK: $33979 ASSOCIATED PERMIT#(if applicable): <br /> (Valuation shall include the prevailing fair market value of all labor,materials,and equipment needed to complete the work,whether actually paid ornot.) <br /> BUILDING TYPE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑✓ICommercial ❑Accessory Structure <br /> DESCRIPTION OF WORK: <br /> Replace 2 AC condensing units with associated cooling coils, per plan. <br /> MECHANICAL PERMIT FIXTURE COUNT (SCOPE OF WORK) <br /> Fixture Fixture <br /> Count List of Fixtures Count List of Fixtures <br /> lQtyl (Qry) <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): yr* <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 <br /> Duct System(additions,alterations) Unit heater(commercial use) <br /> Exhaust Fan(residential or commercial use) lWater Heater(gas or electric) <br /> Exhaust Hood(residential over stove) Wood/Pellet Stove or Insert <br /> Exhaust Hood Type 1 *** 2 Other(List Type):Hyac-Roof M—mi <br /> Exhaust Hood Type 11 *** 2 Other(List Type):coorno can <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 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.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 /> Ofoilal�r vGneQ by Pmmo1e a�,nry PERMIT# <br /> Ammone BembryaM°�y5 o,,w-, °on-aaamb°,9a 05/04/2023 <br /> /1/L -^ <br /> Oale:2023.OS.d4 05:56:13-070C' <br /> Owner/Authorized Agent Signature Date (Revised 412112022) <br />