4828 DELAWARE AVE 2024-11-01 - Laserfiche WebLink

r 'CEINE MELHANICAL PERMIT APPLICA I • ' CITY OF EVERETT PERMIT SERVICES MAR 0 8 2023 J EVERETT SUBMITTAL INSTRUCTIONS:Drop off hard copy paper application&plan to 'I 1 edar Street 2nd Floor Intake p Box. WASHINGTON CONTACT INFORMATION: (P)425.257.8810 I(E)everetteps@everettwa.gov I(WCC rirytyr&r errmt�FTT (Blue or Black Ink Only Please) PROJECT SITE INFORMATION Pprmit SeVrrvit c s PROJECT SITE ADDRESS: STREET 4 2..P3 batiJf\- PARCEL#: CITY EVER 1 1 STATE W A ZIP QS62C 3 SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION: TENANT/BUSINESS NAME(if non-residential): CONTACT INFORMATION OWNER NAME: ©L4Lf5 Ffrmlt,y I1,01-b 3c UV(NIU-T?2i61 OWNER MAILING ADDRESS: STREET 7,�(y zi- t1 J! Il�\Aj oRy 4 apt-cr....- CITY U alag.Tr. i STATE ul A ZIP Q 'Ll�3 OWNER PHONE: 4245 - 3©6 -- 1370 OWNER EMAIL: doh�W-5C,uci•ccrc' ONTRACTOR COMPANY NAME:Coy kill( WA STATE CONTRACTOR LICENSE#(1t:01.1]y(ii I.2Zwk CITY OF EVERETT BUSINESS LICENSE#(RED)2LiO(yq sk Ke CONTRACTOR ADDRESS: STREET 2 22( I.tAve ��r CITY /�U N( fl STATE (A '' l ZIP -1 V�� CONTRACTOR PHONE: 3( - 43,�j 4Ci�j CONTRACTOR EMAIL: ihtu ey I a r j ri C, x c ovn PRIMARY CONTACT: ❑OWNER 14-CONTRACTOR El OTHER(Please Specify) I CONTACTn NAME: CONTACT PHONE: 4E5--259 -�E3'7 3 C�1 eJ-� 5TPQI- CONTACT EMAIL:Urir(5•totI{ e , C6n3trUch Ca �'llama,' I.tU� ' ��" M ANICAL PERMIT INFORMATION ': VALUATION OF WORK: \500 ASSOCIATED PERMIT#(if applicable) 0 230:3 ©3 Z (Valuation shall include the prey ing fair market value of ail l , aterials,and equipment needed to complete the work,whether actually paid or not.) BUILDING TYPE: LISFR LTownhouse ❑Duplex YLADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure DESCRIPTION OF WORK: 2 t rtt Fr}Nsi t W tit LE i1vLtS i FAi. t U12.y(-312—V8 TI 2 A t:Csie Vet.ir i 1,1 taCMCbel- 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) I Gas Piping-List#of outlets in fixture count Air Handling Unit** 1 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) I Clothes Dryer Exhaust Hydronic Piping Duct System(additions,alterations) Unit heater(commercial use) 3 Exhaust Fan(residential or commercial use) I 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 1 am authorized by the owner of this property to perform the work for which application is made, and 1 comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only f3wtrkt fe 3 ,3 . 2 P I-` —al0 Owner/Authorized Agent Si natf Date (Revised 2/8/2021)