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MECHANICAL PERMIT APPLICATION <br />EVERETT <br />WASHINGTON <br />CITY OF EVERETT PERMIT SERVICES <br />SUBMITTAL INSTRUCTIONS: Drop off hard copy paper application & plan to 3200 Cedar Street 2nd Floor Intake Drop Box. <br />CONTACT INFORMATION: (P) 425-257-8810 1 (E) PermitServices@everettwa.gov I (W) everettwa.gov/permits <br />(Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br />PROJECT SITE ADDRESS: STREET 3501 Colby Ave PARCEL #: 01063800002300 <br />CITY Everett STATE WA ZIP 98201 <br />SUITE/UNIT #: FLOOR #: Rooftop ADDITIONAL LOCATION INFORMATION: <br />TENANT/BUSINESS NAME (if non-residential): Grenwich Building <br />CONTACT INFORMATION <br />OWNER NAME: GRENWICH HOLDINGS LLC <br />OWNER MAILING ADDRESS: STREET PO BOX 1091 <br />CITY SNOHOMISH STATE WA ZIP 98291 <br />OWNER PHONE: 425-334-9700 x321 (Meranda Conwell) <br />OWNER EMAIL: mcconwell@conwellassociatesinc.com (Meranda Conwell) <br />CONTRACTOR COMPANY NAME: PSR Mechanical <br />WA STATE CONTRACTOR LICENSE #(REQUIRED): PSRMEML809C6 <br />CITY OF EVERETT BUSINESS LICENSE #(REQUIRED): 018564 <br />CONTRACTOR ADDRESS: STREET 3132 NE 133rd St <br />CITY Seattle STATE WA ZIP 98125 <br />CONTRACTOR PHONE: 206-367-2500 <br />CONTRACTOR EMAIL: Chris.Stone@psrmechanical.com <br />PRIMARY CONTACT: ❑ OWNER 0 CONTRACTOR ❑ OTHER (Please Specify) <br />CONTACT NAME: Chris Stone <br />CONTACT PHONE: 206-573-6130 <br />CONTACT EMAIL: Chris.Stone@psrmechanical.com <br />MECHANICAL PERMIT INFORMATION <br />VALUATION OF WORK: $ 11802 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: FICommercial ❑Accessory Structure <br />DESCRIPTION OF WORK: <br />Replace Existing RTU 3-2. New unit requires curb adapter. <br />MECHANICAL PERMIT FIXTURE <br />COUNT (SCOPE OF WORK) <br />Fixture <br />Count <br />(Qty) <br />List of Fixtures <br />Fixture <br />Count <br />(Qty) <br />List of Fixtures <br />A/C Unit (attach plan with location of outdoor unit) <br />Gas Piping - List # of outlets in fixture count <br />Air Handling Unit ** <br />Gas Appliance ** <br />Boiler (most require backflow prevention) ** <br />Gas Fireplace, Insert, and/or Log (* for commercial bldgs) <br />Commercial Refrigeration (Walk-in coolers, VRF, VRV, etc.) <br />Gas - Other (List Type): ** <br />Commercial Ventilation (corridors, stairwell, pressurization, etc.) <br />Heat Pump (attach plan with location of outdoor unit) <br />Compressors/Generators (building permit may be required) ** <br />Heat Pump Ductless (attach plan with location of outdoor unit) <br />Clothes Dryer Exhaust <br />Hydronic Piping <br />Duct System (additions, alterations) <br />Unit heater (commercial use) <br />Exhaust Fan (residential or commercial use) <br />Water Heater (gas or electric) <br />Exhaust Hood (residential over stove) <br />Wood/Pellet Stove or Insert <br />Exhaust Hood Type I *** <br />Other (List Type): <br />Exhaust Hood Type II *** <br />Other (List Type): <br />Furnace (residential) <br />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 #'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 1 am authorized by the owner of this property to perform the work for which application is made, <br />and 1 comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />City of Everett Official Use Only <br />Digitally signed by Chris Stone PERMIT # <br />ChrisStone ONPSR Me hanical, CNeCChrrss Stonenical com, 5/11 /2023 <br />Date: 2023.05.11 1014709-07'00' <br />Owner/Authorized Agent Signature Date (Revised 412112022) <br />