1023 100TH ST SW 2024-08-07 - Laserfiche WebLink

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)everetteps@everettwa.gov I(W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET /� ,Z7j IC O'er t' S(J PARCEL#: Z ?Q'f I.3 Cj 03 8 J=fU)d CITY coat++ STATE ZIP 736 77 SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION: TENANT/BUSINESS NAME(if non-residential): ( ff CONTACT INFORMATION OWNER NAME: R) IS4e cJ. UU $fialAh COKs fit&Cl I tOV'L OWNER MAILING ADDRESS: STREET 96 /3Q /.` if.1 CITY ni(j/y S 4ri STATE 40iq ZIP 9 z 761 OWNER PHONE: /C5 J7 55 j OWNER EMAIL: L3 s ilctC, t-6w-. vi.tz?mu . t.Ou't. CONTRACTOR COMPANY NAME: ay,5 CL,i S to C 00-5t"ecAC 4Civ\ Z WA STATE CONTRACTOR LICENSE#(REQUIRED): &r.Lst'A(t 9t 3 C bl CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): >�3-J 3G CONTRACTOR ADDRESS: STREET ,7O . 86y, I z 9' CITY /VQ(1 V 50 i//! STATE I I ZIP V 7d CONTRACTOR PHONE: ye " I?/&, -6 5'3 f CONTRACTOR EMAIL:Ba jim✓L (t4A4-41VA- Cot ot4. 00.p j.i. (• PRIMARY CONTACT: KOWNER ❑CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: yec- 7j_6 j, 5 5 , ,y) U.1 4/�S tCL(Ck CONTACT EMAIL: S r1 C/� $'f�►'K(apts i-egc- L'+1 C rot Ot'1 MECHANICAL PERMIT INFORMATION VALUATION OF WORK:$ Z5C1 j OD© 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: Cap. Si-e ef- r' () & Q MECHANICAL PERMIT FIXTURE COUNT (SCOPE OF WORK) Fixture Fixture Count List of Fixtures Count List of Fixtures (QtY) (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) 4/ 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 comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only M ^�C / PERMIT# -0,6u Owner/Authorized gent ignature Date (Revised 2/8/2021)