1520 BROADWAY 2026-01-02 - Laserfiche WebLink

ME HANICAL PERMIT APPLIC TION 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)everetteps@everettwa.gov I (W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 1520 Broadway PARCEL#: cl-y Everett STATE WA zip 98201 SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION: TENANT/BUSINESS NAME (if non-residential):Sunrise Services CONTACT INFORMATION OWNER NAME: Randle West OWNER MAILING ADDRESS: STREET PO BOX 2569 ciTy Everett STATE WA zip 98213 OWNER PHONE:425-293-4598 OWNER EMAIL:randlew@sunriseemail.com CONTRACTOR COMPANY NAME:Evergreen State Heat&AC WA STATE CONTRACTOR LICENSE#(REQUIRED):EVERGSS0220T CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 007955 CONTRACTOR ADDRESS: STREEr8431 Maltby Rd clTy Snohomish STATE WA ... 98296 CONTRACTOR PHONE:425-252-31 14 CONTRACTOR EMAIL:Cliff@eSSmwa.com PRIMARY CONTACT: ❑ OWNER ❑CONTRACTOR ❑ OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: Cliff Anderson CONTACT EMAIL: MECHANICAL PERMIT INFORMATION VALUATION OF WORK: $14695 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 paid or not.) BUILDING TYPE: ❑SFR []Townhouse ❑Duplex ❑ADU []Multi-Family-#Units: ❑✓Commercial ❑Accessory Structure DESCRIPTION OF WORK: Replace 2nd floor RTU MECHANICAL PERMIT FIXTURE COUNT (SCOPE OF WORK) T Fixture List of Fixtures Count List of Fixtures (Qty) A/C 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): t 1 Exhaust Hood Type II *** Other(List Type): Fumace(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. ACKNOWLEDGF WENT 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 federa ate, d 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 Off i eing au r ed 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 1 com State C s Law 18.27 R OA WAC. City of Everett Official Use Only PERMIT# t,i 2- 1 Oq s / Owner/Authorized Agent Signature f Date (Revised 2/8/2021) /�