2410 EVERETT AVE 2024-02-20 - Laserfiche WebLink

MECIVICAL PERMIT APPLICATIN 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)Perm itServices( everettwa.gov I(W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 91/1 �V-(Y-.p.`l / ) " PARCEL#: CRY t STATE Wit- ZIP q �e SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION: TENANT/BUSINESS NAME(if non-residential): CONTACT INFORMATION OWNER NAME:j Olt, �' RQ V A` - (�J'L t CV YID OWNER MAILING ADD&ESS: STRE ),(3 I A) ' 1 /' e/ CITY e V Y.P, STATE Wfr" ZIP q r)--1)1 OWNER PHONE: 2( 2 2 V i Q Q C iOWNER EMAIL.: V.egicAck-e-14.0t.t. b tit `Jyckll D .0 CONTRACTOR COMPANY NAME: UV VvL G (1.ov1 -' W NI EX WA STATE CONTRACTOR LICENSE#(REQUI D): 1 I' CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): N Y n CONTRACTOR ADDRESS: STREET 7 2-3 ) (� P 1 Py Av"C- CITY g A/V,V1 STATE r ZIP ,6ika--(), CONTRACTOR PHONE: 2,t)hl' 9-/ O 1-J y CONTRACTOR EMAIL:Tv t. Vlaq op ) c( i/tve - e() N( PRIMARY CONTACT: OWNER ❑CONTRACTOR 0 OTHER(Please Specify) J CONTACT NAME: CONTACT PHONE: 20 r'0 i r1 1 0 'b$1 R-Q-511/1_k_ (>1/L ot- y_ CONTACT EMAIL: ytA '( L at U n 6 y op CHANICAL PERMIT INFORMATION VALUATION OF WO $ ) D (ASSOCIATED PERMIT#(if applicable): (Valuation shall include the vailing fair market value of a r,materials,and equipment needed to complete the work,whether actually paid or not) BUILDING TYPE: gS se ❑Duplex DADU ❑Multi-Family-#Units: ❑Commercial DAcrpssory Structure DE CRIPTION OF WORK: V V , 04- r/4$-e tQ-VLF' MECHANICAL PERMIT FIXTURE COUNT(SCOPE OF WORK) Fixture Fixture Count List of Fixtures Count List of Fixtures (QtY) (QtW) 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): Furnace(residential) Other(List Type): it 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 1 am authorized by the owner of this property to perform the work for which application is made, and I comply with the State Contractors Law 18.27 RCW and 298.200A WAC. cLCity of Everett Official Use Only aCPJ g/23 �j PERM # rlAutho' Agent Signature Date (Revised 4/21/2022)