3405 ROCKEFELLER AVE A, B, C 2025-04-17

MECHANICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES E V E R E T T 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)PermitServices@everettwa gov (W)everettwa gov/permits r WASMINGTON - (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 4 Gr 4� h" t(farAV PARCEL#: STATE W /� �ah ZIP CITY b V C,Y•{+- !!/I SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION: TENANT/BUSINESS NAME (if non-residential): CONTACT INFORMATION OWNER NAME: HGr 'Pt 6'r-k OWNER MAILING ADDRESS: STREET (G y rUr Fh4j '^' ZIP QGT CITY V[r"tf•� w,4 STATE VV OWNER PHONE: Z 5- jl�- (;S5 5 OWNER EMAIL: 6 CONTRACTOR COMPANY NAME: /I/It c Li:e�Irw. I%cv-) y WA STATE CONTRACTOR LICENSE#(REQUIRED):/-�� G� II Glt C CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): O / CONTRACTOR ADDRESS: STREET L`5G i PtG�.fc,- f Ave- 9 1 c, 3 �7� d CITY S STATE lr•/.rT ZIP �7 ZyG ��G�h�...;-� 1, CONTRACTOR PHONE: [ �clrf ��o`(7` CONTRACTOR EMAIL: n �j;r I, q U.,rf&c•h•Cc' PRIMARY CONTACT: WNER ❑CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: CONTACT EMAIL: MECHANICAL PERMIT INFORMATION VALUATION OF WORK: $ i ('O ) ASSOCIATED PERMIT#(if applicable): IJ 2 ZD �— 6`33 (Valuation shall Include the prevailing fair market value of all labor,materials,and equipment needed to complete the work,whether actually paid or not) BUILDING TYPE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ommercial ❑Accessory Structure DESCRIPTION OF WORK: UA �( / / �Jp �),t;/aJ;.1 `�f lt`e- II"' /^4,t, tic ti/cct I l[I/— ��1aI�� / 'r al/ 1� V� rcra�f MECHANICAL PERMIT FIXTURE COUNT (SCOPE OF WORK) EFixtureFixture List of FixturesCount List of Fixtures (Q(Y) A/C Unit(attach plan with location of outdoor unit) o Gas Piping-List#of outlets in fixture count Air Handling Unit** Gas Appliance** G Boiler(most require backflow prevention) ** O Gas Fireplace, Insert,and/or Log(*for commercial bldgs) Gas-Other List T e ** C Commercial Refrigeration(Walk-in coolers,VRF,VRV,etc) � l YP ) C lCommercial 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 0 Hydronic Piping G I Duct System(additions,alterations) Unit heater(commercial use) t( Exhaust Fan(residential or commercial use) lWater Heater(gas or electric) [1) Exhaust Hood(residential over stove) Wood/Pellet Stove or Insert cl Exhaust Hood Type I *** i Other(List Type): Exhaust Hood Type II *** / Other(List Type): Other(List Type): O Furnace(residential) * 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 1 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 Budding 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 1 comply with the State Contractors Law 18 27 RCW and 296 200A WAC City of Everett Official Use Only PERMIT# 2 ' __3 jk Owner/Authorized Agen Signature Date (Revised 412112022)