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MECHANICAL PERMIT APPLICATION <br />EVERETT <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 />W 4S H I NI, IUN <br />(Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br />PROJECT SITE ADDRESS: STREET 1816 112TH ST SE PARCEL #: <br />CITY EVERETT STATE WA nN 98208 <br />SUITE/UNIT #: FLOOR #: ADDITIONAL LOCATION INFORMATION: <br />TENANT/BUSINESS NAME (if non-residential):SILVERLAKE 76 <br />CONTACT INFORMATION <br />OWNER NAME: FASAL KHAN <br />OWNER MAILING ADDRESS: STREET 1816 112TH ST SE <br />CITY EVERETT `TATE WA zip 98208 <br />OWNER PHONE:425-985-1622 1OWNER <br />EMAIL: SILVERLAKE76@GMAIL.COM <br />CONTRACTOR COMPANY NAME:PYE BARKER FIRE <br />WA STATE CONTRACTOR LICENSE #(REQUIRED): PYEBAFS807DO <br />ICITY OF EVERETT BUSINESS LICENSE #(REQUIRED): <br />CONTRACTOR ADDRESS: sTUE1,735 E FAIRHAVEN AVE <br />CITY BURLINGTON ;, WA Z1E 98233 <br />CONTRACTOR PHONE:360-755-5444 <br />1CONTRACTOR EMAIL:TAYLORN@PYEBARKERFIRE.COM <br />PRIMARY CONTACT: ❑ OWNER ✓ CONTRACTOR OTHER (Please Specify) <br />CONTACT NAME N I S HA TAYLO R <br />CONTACT PHONE:360-755-5444 <br />CONTACT EMAIL:TAYLORN c@PYEBARKERFIRE.COM <br />MECHANICAL PERMIT INFORMATION <br />VALUATION OF WORK: $1600.00 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: LJSFR OTownhouse F]Duplex ❑ADU ❑Multi -Family - # Units:_ ✓(Commercial I (Accessory Structure <br />DESCRIPTION OF WORK: <br />SELF CONTAINED FRYER ADDED - FIRE SUPPRESSION SYSTEM TO BE COMMISSIONED <br />MECHANICAL PERMIT FIXTURE <br />COUNT (SCOPE OF WORK) <br />Fixture <br />Count <br />(Qfy) <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 />Boller (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 *** Other (List Type). <br />Furnace (residential) 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 ars <br />*** described in the associated Checklists online at everettwa.gov/permits under the Checklists & Handouts tab. <br />ACKNOWLEDGEMENT. 1 have reviewed this application and confirm the information contained heroin 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 I am authorized by the owner of this property to perform the work for which application is made. <br />and I rnrnuly with the State Contractors Law 18.27 RCW and 296.200A WAC <br />City of Everett Official Use Only <br />PERMIT # <br />(Revised 412112022) <br />