1622 HOYT AVE 2024-08-08 - Laserfiche WebLink

�I EVERETT MECHANICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES SUBMITTAL INSTRUCTIONS: Drop off hard copy paper application & plan to 3200 Cedar Street 2nd Floor Intake Drop Box. CONTACT INFORMATION: (P) 425.257.8810 1 (E) everetteps@everettwa.gov I (W) everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS:1L2t STREET }1a 0,pt- PARCEL M CITY E Vt�—tf STATE W A ZIP SUITE/UNIT #: FLOOR #: ADDITIONAL LOCATION INFORMATION: TENANT/BUSINESS NAME (if non-residential): CONTACT INFORMATION OWNER NAME: C { \b t, },c, OWNER MAILING ADDRESS: STREET 162Z N-} (\— CITY tic.,mt,\ STATE Irh(j ZIP OWNER PHONE: y7S -77 7- vcS 11 OWNER EMAIL: rc • c�n,tc ,c t,v� �\ c �{ �i r ti;t,��r CONTRACTOR COMPANY NAME: WA STATE CONTRACTOR LICENSE #(REQUIR fqN C Q_!- 7.871< ITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 6600 CONTRACTOR ADDRESS: STREET jq4Q VL Su CnY 5rc.\.Ft1�L STATE (j ZIP `Ism, CONTRACTOR PHONE: c (2S• 7"7 2 • bStt CONTRACTOR EMAIL: PRIMARY CONTACT: [� OWNER POCONTRACTOR ❑ OTHER (Please Specify) CONTACT NAME: CONTACT PHONE: kA25 _777- '01% CONTACT EMAIL: MECHANICAL PERMIT INFORMATION VALUATION OF WORK: $ \ U o ASSOCIATED PERMIT # (if applicable): (?-W 57 Zq (Valuation shall Include the preva0ing fair market value of all labor, materials, and equipment needed to complete the work, whether actually paid or not.) BUILDING TYPE: NSFR ❑Townhouse ❑Duplex ❑ADU ❑Multi -Family - # Units: ❑Commercial ❑Accessory Structure DESCRIPTION OF WORK: Snjtin\t ex\�c vJi (-u MECHANICAL PERMIT FIXTURE COUNT (SCOPE OF WORK) Fixture Count Ply) List of Fixtures Fixture Count (Qfy) List of Fixtures 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 bidgs) 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 maybe 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): * For commercial gas fireplaces, please attach plans and manufacturer's installation manual. * * 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 connrm the inrormarion contained herein is true and correct. worK oone pursuant io uns pennn roust cumpry whir 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 whiling 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 Qont7We ors Law 18.27 RCW and 296.200A WAC. Agent Signature 712.,1123 Date City of Everett Official Use Only PERMIT # f1'A 30 7' o$s' (Revised 21812021)