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MECHANICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> EVERETT SUBMITTAL INS i rcUCTIONS: Drop off hard copy paper application&plan to 3200 Cedar Street 2nd Floor Intake Drop Box. <br /> WASHINGTON CONTACT INFORMATION: (P)425.257.8810 I(E)everetteps@everettwa.gov I(W)everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: STREET 7800 Evergreen Way PARCEL#: 28050700300700 <br /> CITY Everett STATE WA ZIP 98203 <br /> SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION: <br /> TENANT/BUSINESS NAME(if non-residential):Lee Johnson Hyundai of Everett <br /> CONTACT INFORMATION <br /> OWNER NAME: LMJ Enterprises LP <br /> OWNER MAILING ADDRESS: STREET 11845 NE 85th St <br /> CITY Kirkland STATE WA ZIP 98033 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR COMPANY NAME:Evergreen Refrigeration <br /> WA STATE CONTRACTOR LICENSE#(REQUIRED):EVERGRL954R2 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 044350 <br /> CONTRACTOR ADDRESS: STREET 727 S Kenyon St <br /> CITY Seattle STATE WA ZIP 98108 <br /> CONTRACTOR PHONE:206-763-1744 CONTRACTOR EMAIL:alexb@evergreenhvac.com <br /> PRIMARY CONTACT: ❑OWNER ❑✓ CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME:Alex Burkhart CONTACT PHONE:206-763-1744 ext.247 <br /> CONTACT EMAIL:alexb@evergreenhvac.com <br /> MECHANICAL PERMIT INFORMATION <br /> VALUATION OF WORK: $147,622.00 ASSOCIATED PERMIT#(if applicabld):B2204-005 <br /> (Valuation shall include the prevailing fair market value of all labor,materials,and equipment needed to complete the work,whether ac ally paid or not.) <br /> BUILDING TYPE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ally <br /> ❑Accessory Structure <br /> DESCRIPTION OF WORK: <br /> Installation of three(3)rooftop units,three(3)energy recovery ventilators,two(2)electric duct heaters,one(1)gas unit heater, <br /> four(4)exhaust fans,two(2)roof hoods,ductwork,grilles/diffusers,and four(4)gas piping outlets. <br /> MECHANICAL PERMIT FIXTURE COUNT (SCOPE OF WORK) <br /> Fixture Fixture <br /> Count List of Fixtures Count List of Fixtures <br /> (QtY) (Qtv) _ <br /> NC Unit(attach plan with location of outdoor unit) i Gas Piping-List#of outlets in fixture count <br /> 3 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.) 3 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 /> 3 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 *** 2 Other(List Type):Elednc Heater <br /> Exhaust Hood Type II *** 2 Other(List Type):Roof hood — <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 I am authorized by the owner of this property to perform the work for which application is made, <br /> and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official UseUse Only <br /> PERMIT# <br /> 3/16/23 nna <br /> Owner/Authorized Agent Signature Date (Revised 2/8/2021) <br />