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2515 HOYT AVE 2025-01-06
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2515 HOYT AVE 2025-01-06
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1/6/2025 9:56:53 AM
Creation date
12/17/2024 10:14:39 AM
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Street Name
HOYT AVE
Street Number
2515
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MECHANICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> EVERETT SUBMITTAL INSTRUCTIONS: Drop off hard copy paper application&plan to 3200 Cedar Street 2nd Floor Intake Drop Box. <br /> WASHINGTON CONTACT INFORMATION: (P)425-257-8810 1 (E)PermitServices@everettwa.gov I(W)everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: STREET 2517 HOYT AVE PARCEL M 00562456100900 <br /> CITY Everett STATE WA ZIP 98201 <br /> SUITE/UNIT#: FLOOR M 1st floor ADDITIONAL LOCATION INFORMATION: boiler room east side of building <br /> TENANT/BUSINESS NAME(if non-residential):OUR LADY OF HOPE <br /> CONTACT INFORMATION <br /> OWNER NAME: IMMACULATE CONCEPTION PARISH-EVERETT <br /> OWNER MAILING ADDRESS: STREET 710 NINTH AVE <br /> CITY Seattle STATE WA Zip 98104 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR COMPANY NAME:PSR Mechanical <br /> WA STATE CONTRACTOR LICENSE#(REQUIRED):PSRMEML809C6 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 018564 <br /> CONTRACTOR ADDRESS: STREET 3132 NE 133rd St <br /> CITY Seattle STATE WA ZIP 98125 <br /> CONTRACTOR PHONE:206-367-2500 CONTRACTOR EMAIL:Chris.Stone@psrmechanical.com <br /> PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR ❑ OTHER(Please Specify) <br /> CONTACT NAME: Chris Stone CONTACT PHONE:206-573-6130 <br /> CONTACT EMAIL:Chris.Stone@psrmechanical.com <br /> MECHANICAL PERMIT INFORMATION <br /> VALUATION OF WORK: $54,672 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: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: FICommercial ❑Accessory Structure <br /> DESCRIPTION OF WORK: <br /> Replace existing hydronic bailer and expansion tank.Demo existing and install new drain piping for new boiler relief valve,expansion tank,bypass filter feeder,airldld separator,and existing air vents.Demo and install new gas piping,valve,regulator,and pressure <br /> MECHANICAL PERMIT FIXTURE COUNT (SCOPE OF WORK) <br /> Fixture Fixture <br /> Count List of Fixtures Count List of Fixtures <br /> (Qty) (Qty) <br /> A/C Unit(attach plan with location of outdoor unit) Gas Piping-List#of outlets in fixture count <br /> Air Handling Unit** Gas Appliance** <br /> Boiler(most require backflow prevention)** Gas Fireplace,Insert,and/or Log(*for commercial bldgs) <br /> Commercial Refrigeration(Walk-in coolers,VRF,VRV,etc.) Gas-Other(List Type): ** <br /> Commercial Ventilation(corridors,stairwell,pressurization,etc.) Heat Pump(attach plan with location of outdoor unit) <br /> Compressors/Generators(building permit may be required)** Heat Pump Ductless(attach plan with location of outdoor unit) <br /> Clothes Dryer Exhaust Hydronic Piping <br /> Duct System(additions,alterations) Unit heater(commercial use) <br /> Exhaust Fan(residential or commercial use) Water Heater(gas or electric) <br /> Exhaust Hood(residential over stove) Wood/Pellet Stove or Insert <br /> Exhaust Hood Type I *** 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 as <br /> *** described in the associated Checklists online at everettwa.gov/permits under the Checklists&Handouts tab. <br /> 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 <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 1 am authorized by the owner of this property to perform the work for which application is made, <br /> and 1 comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> Digitally signed by Chris Stone PERMIT# <br /> ChrisStone ONPSR Me hanical,CNeCChrrss Stone nical com, 3/�3/202 A <br /> Date:2024.03.13 08:17:34-07'00' I `F <br /> Owner/Authorized Agent Signature Date (Revised 412112022) <br />
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