4230 COLBY AVE 2023-10-20 - Laserfiche WebLink

wim 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)PermitServices@everettwa.gov I(W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 4-42_ CUr ko t j e_ PARCEL#: ,jO5(2,22()2 i()D S( O CITY l• C. VVC.-k* STATE to \ ZIP -{e Z© 3 SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION: TENANT/BUSINESS NAME(if non-residential): .p..e ��"� - I ii 11 t n CONTACT INFORMATION �) OWNER NAME: 1/14e,tlt' F ` V c OWNER MAILING ADDRESS: STREET 4 1.3O L �O Y I v CITY 0 11-e•{' STATE \IJ 3 ZIP cif O 3 OWNER PHONE: �-2�j �� • 1 LL) OWNER EMAIL: E�G1. h -ei Y�t%YI L I=-LSC��'1 I1or 11y"i�►tc1 -G ' CONTRACTOR COMPANY NAME: Evergreen State Heat&AC WA STATE CONTRACTOR LICENSE#(REQUIRED):EVERGSSO22OT CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 007955 CONTRACTOR ADDRESS: STREET 8431 Maltby Rd CITY Snohomish STATE WA zip 98296 CONTRACTOR PHONE: 425-252-3114 CONTRACTOR EMAIL: Cliff@essmwa.com PRIMARY CONTACT: ❑OWNER �J ❑✓ CONTRACTOR^ ❑OTHER(Please Specify) CONTACT NAME:CIIII{� AC�UPI-SOI1 CONTACT PHONE:425-252-3114 CONTACT EMAIL:cliff@essmwa.com MECHANICAL PERMIT INFORMATION VALUATION OF WORK: $ L I,D.t K7-r, ASSOCIATED PERMIT#(if applicable): (Valuation shall include the prevailing fair market'value of all labor,materials,and equipment needed to complete the work,whether actually,,p�paid or not.) BUILDING TYPE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: Leommercial ❑Accessory Structure DESCRIPTION OF WORK: tpl c ?f PLL a s ), J 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) 2 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): 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 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. 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 I am authorized by the owner of this property to perform the work for which application is made, and I cfr - Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT# Owner Signature Date (Revised 4/21/2022) 147_