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WAR <br /> MECHANICAL PERMIT APPLICATION D 1E©1llV ' <br /> CITY OF EVERETT PERMIT SERVICES <br /> E V E R E T T SUBMITTAL INSTRUCTIONS: Drop off hard copy paper application&plan to 3200 Ced eet 2 ogtl Intal grop Bo <br /> WASHINGTON <br /> CONTACT INFORMATION: (P)425-257-8810 I (E)PermitServices@everettwa.gov I (W) v ettwa.gov/p its <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION CITY nF EVERCTT <br /> PROJECT SITE ADDRESS: STREET 3 &t.j3/ `���C� '_4,5(4O �^` b PARCEL#: 2s/o415loo400sao Permit ServlCeS <br /> Everett (fin)cJ'`( (,dJ'vTl`�' - o1(J I I[I O l <br /> CITY 111 c ` STATE wA zip 98204 <br /> SUITE/UNIT#: E( & a,O)FLOOR#: 1 ADDITIONAL LOCATION INFORMATION: <br /> TENANT/BUSINESS NAME (if non-residential):Bright Horizons Everett <br /> CONTACT INFORMATION <br /> OWNER NAME: BOEING COMPANY <br /> OWNER MAILING ADDRESS: STREET PO BOX 52427 <br /> CITY Atlanta STATE GA ZIP 30355 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR COMPANY NAME:MacDonald Miller Facility Solutions <br /> WA STATE CONTRACTOR LICENSE#(REQUIRED):: MACDOFS808OS CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 040665 <br /> CONTRACTOR ADDRESS: STREET PO Box 47983 <br /> CITY Seattle STATE WA ZIP 98146 <br /> CONTRACTOR PHONE:206-768-4062 CONTRACTOR EMAIL:Permits@macmiller.com <br /> PRIMARY CONTACT: ❑OWNER ❑✓ CONTRACTOR ❑ OTHER(Please Specify) <br /> CONTACT NAME:Am CYl O n e BPi Cl'1 bYy CONTACT PHONE:206-768-4062 <br /> CONTACT EMAIL:permits@macmiller.com <br /> MECHANICAL PERMIT INFORMATION <br /> VALUATION OF WORK: $25000 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 or not) <br /> BUILDING TYPE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑✓Commercial ❑Accessory Structure <br /> DESCRIPTION OF WORK: <br /> Install new makeup air fan, duct heater, and associated duct and grilles to serve existing kitchen. <br /> MECHANICAL PERMIT FIXTURE COUNT (SCOPE OF WORK) <br /> Fixture Fixture <br /> Count List of Fixtures Count List of Fixtures <br /> (Qty) (QtY) <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): ** <br /> Commercial Ventilation(condors,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) Water Heater(gas or electric) <br /> Exhaust Hood(residential over stove) Wood/Pellet Stove or Insert <br /> Exhaust Hood Type I *** 2 Other(List Type):Dinusers <br /> Exhaust Hood Type II *** t Other(List Type):Electric Duct Heater <br /> Furnace(residential) , Other(List Type): Makeup Nr System <br /> * For commercial gas fireplaces,please attach plans and manufacturer's installation manual. <br /> ** Under Description of Work,please include Type of Equipment,model#'s,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 /> Opltelly signed by Ammone eembry PERMIT# <br /> Oft C=US,E=ammone.bembry@macmiller.cam,A m m o n e B e m b ry O-MA Door^la=ryF acility Solutions.OU=Perm 03/07/2023 <br /> it Specialist, / 3 03 .3( ``. <br /> Date:2023.03.07 01153:13.06'00' VY� <br /> Owner/Authorized Agent Signature Date (Revised 4/21/2022) <br />