3006 15TH ST 2024-12-09 - Laserfiche WebLink

NON EVERETT WASHINGTON MECHANICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES SUBMITTAL INSTRUCTIONS: Drop off hard copy paper application 8 plan to 3200 Cedar Street 2nd Floor Intake Drop Box. CONTACT INFORMATION: (P) 425.257.8810 1 (E) everetteps@everetlwa.gov I (W) everetlwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET ✓()ijfh PARCELS: 0 6 U CITY E Via Pj' STATE ZIP SUITEMNIT #: FLOOR #: ADDITIONAL LOCATION INFORMATION: TENANT/BUSINESS NAME (if non-residential): CONTACT INFORMATION OWNER NAME: David 6mitkLIr-� OWNER MAILING ADDRESS: STREET S,f e cm Coewf- e-4 Aleoa STATE ZIP S3 g/ CJ OWNER PHONE: q, Lj 53 I ' I I [9 I OWNER EMAIL: CONTRACTOR COMPANY NAME: AJIA owyier A STATE CONTRACTOR LICENSE #(REQUIRED): IVIA ICITY OF EVERETT BUSINESS LICENSE #(REQUIRED): AJIA CONTRACTOR ADDRESS: STREET Al 1A CITY STATE ZIP CONTRACTOR PHONE: NIA CONTRACTOR EMAIL: AIIA PRIMARY CONTACT: OWNER ❑ CONTRACTOR ❑ OTHER (Please Specify) CONTACT NAME: Q(lid SVArNAbuV CONTACT PHONE: CONTACT EMAIL: Si - wtf'o 0(& 4141okI Caµ MECHANICAL PERMIT INFORMATION VALUATION OF WORK: $ �'-� 060 JASSOCIATED PERMIT # if applicable): (Valuation shall include the prevailing fair market value of all labor, materials. and equipment needed to complete the work, whetheraclualy paid or mt.) BUILDING TYPE: ❑SFR ❑Townhouse Zuplex ❑ADU ❑Multi -Family- #Units: ❑Commercial ElAccessory Structure DESCRIPTION OF WORK: M,('J,kl? IMIA,;f LVIA4,j,2$ 'i'O (OI.G'etr �Ip cii / Creln �(J"i P�t(/(� N1OVe- 0.. ItavtLeAA I yj 0 F ekxq e (�;kL 6r-6� 14A ," e a i MECHANICAL PERMIT FIXTURE COUNT (SCOPE OF WORK) Fixture Count (City) List of Fixtures Fixture Count 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 bldgs) Commercial Refrigeration (Walk-in coolers, VRF. VRV, eta) 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, ateratbns) 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 ueplaces, please attach plans and manufacturers 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. ov/ ermits under the Checklists 8 Handouts tab. ACKNOMLEDGEMENT r rwve reviewed ions appacanon and con nrm the Information contained herein is true and correct. wdnr done pursuant to this permit must comply with current federal, state, and local law. The granting of a pemut 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 l comply with the State Contractors Lew 18. 27 RCW and 296.200A WAC City of Everett Official Use Only PERMIT # (Revised 2WO21) U