9227 4TH AVE W 2024-08-12 - Laserfiche WebLink

MECHANICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES E V E R E T T 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 1(E)PermitServices@everettwa.gov (VV)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET9227 4th AVE W PARCEL#: 00480200101801 c,n Everett STATE WA zip 98204 SUITEWNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION: TENANT/BUSINESS NAME(if non-residential): CONTACT INFORMATION OWNER NAME: Adis Zlzak OWNER MAILING ADDRESS: STREET 1104 178th ST SW cIn Lynnwood STATE WA zip 98037 OWNER PHONE:4255-268-255155 OWNER EMAIL:Na andesi n@ mail.com CONTRACTOR COMPANY NAME:Na a Homes LLC WA STATE CONTRACTOR LICENSE#(REQUIRED):NAPAHHL798JM CITY OF EVERETT BUSINESS LICENSE#(REQUIRED):64947 CONTRACTOR ADDRESS: sTREETI 104 178th ST SW c,TY Lynnwood STATE WA ,, 98037 CONTRACTOR PHONEA255-268-2551 55 CONTRACTOR EMAIL:napandeslgn@gmal.com PRIMARY CONTACT: [D OWNER ❑CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:4255-268-255155 Adis Zizak CONTACT EMAlUnapal-idesign@gmail.com MECHANICAL PERMIT INFORMATION VALUATION OF WORK:$12,000 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 E]Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure DESCRIPTION OF WORK: Construct a new duplex with all new mechanical work. Heat pump: dyken. Unit 1 installer 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 4fmk 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): *�Y Commercial Ventilation(corridors,stairwell,pressurization,etc.) Heat Pump(attach plan with location of outdoor unit) Compressors/Generators(building permit may be required)mkak 2 Heat Pump Ductless(attach plan with location of outdoor unit) 2 Clothes Dryer Exhaust Hydronic Piping Duct System(additions,alterations) Unit heater(commercial use) Exhaust Fan(residential or commercial use) 2 Water+leelef(gas or eta irc) Sega. L O 2 Exhaust Hood(residential over stove) Wood/Pellet Stove or Insert Exhaust Hood Type I iemkmlk Other(List Type): Exhaust Hood Type II akmk9lr Other(List Type): Furnace(residential) Other(List Type): mk For commercial gas fireplaces,please attach plans and manufacturer's installation manual. mkmk Under Description of Work,please include Type of Equipment,model Vs,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 Oficial before being authorized under any circumstance.l 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 Oficial Use Only PERMIT# M -3 v 0 83 Ownerl uthorized Agent na ure Date (Revised 4/21/2022)