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PERMIT APPLICATION <br /> ii <br /> �'� BUILDING I MECHANICAL/PLUMBING /SIGN I SPRINKLER/ DEMOLITION <br /> sCITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> (Blue or Black Ink Only Pleas.) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS:522 COLEY AVE PROPERTY TAX#:00496813004400 <br /> LEGAL for new construction: Short Plat/subdivision <br /> Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION i <br /> OWNER NAME: JOSEPH MUNN <br /> TENANT BUSINESS NAME(Commercial): <br /> OWNER MAILING ADDRESS: STREET 522 COLBY AVE <br /> cm, EVERETT STATE WA ZIP 98201 , <br /> OWNER PHONE: 425-2594394 !OWNER EMAIL:munnjess88@msn.corn . <br /> CONTRACTOR NAME:C.M. HEATING INC <br /> CONTRACTOR ADDRESS: STREET 1415 BROADWAY <br /> c+Tv EVERETT STATE WA ZIP 98201 <br /> CONTRACTOR PHONE:425-259-0550 'CONTRACTOR EMAIL:KAiLANA@CMHEATING.COM <br /> CONTRACTOR LICENSE#(REQUIRED):CMHEAI*09554 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 016098 <br /> PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:425-259-0550 <br /> KAiLANA CONTACT EMAIL:KAiLANA@CMHEATING.COM <br /> BUILDING INFORMATION <br /> Existing Use of Building. Contract Price of Work:$10750 <br /> Proposed Use of Building: Heat Source: DGas DElectric Doth r _ <br /> BUILDING USE: DSFR STownhouse ❑Oupiex ❑ADU LiMulti-Family-#Units: ECommercial DAccessory Structure — _. <br /> Type of Project: ©New ❑Addition ❑Remodel ERepair ET.I, OSign QSprinkter ❑Demolition iUUChange of Use <br /> DESCRIPTION OF WORK: A/C INSTALLATION <br /> ASSOCIATED BUILDING PERMIT#(if applicable) <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Fixture Fixture Fixture <br /> count List of Fixtures List of Fixtures List of Fixtures Fixture <br /> Count Count List of Fixtures <br /> i NC—Air Handling Units Gas Piping ` Count <br /> A 9 Backflow Preventer(Inside Bldg) Shower.Tub,or Combo <br /> Boiler Gas Range Clothes Washer1 <br /> Dryer <br /> Clothes Sink-Commercial(3•Comp,prep,ftorl <br /> Heat Pump&Ductless Dishwasher Sink-Residential(kitchen <br /> bath,bar) <br /> .Duct System(Remodel) ,Refrigeration Drinking Fountain Sink-Utility,laundry,mop <br /> Exhaust Fans(Residential) Commercial Ventilation Floor Drain <br /> Exhaust Hood(Type I) Urinal <br /> (Net Heat/AC system) Hose Bibb Urinal let <br /> -""' <br /> Exhaust Hood(Type II) Water Heater Interceptor-Grease <br /> Exhaust Hood(Residential) Wood Stove p Water M/ater Piping Repair <br /> Interceptor-Sand/Oil Water Service(behind meter) , <br /> Forced Air Systems Other Medical Gas <br /> Gas Fireplace/insert/Log Water Valves or Fixtures <br /> Roof Drains Water Heater <br /> SPRINKLER/SUPPRESSION SYSTEM Sewage Elector or SumpPump Other:Water Suppression System No.of HeadsChemical Suppression System ( �No.of Heads <br /> —. <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, l <br /> and i comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> / j City of Everett Official Use Only <br /> ,Jc-.cY/G✓.t�I 711,6744°11 PERM T.# <br /> CSI07/11/19 1 , \lC CO <br /> iOwner/Authorized Agent Signature s"� ` \O l"" <br /> Date (Revised 011012018) <br /> i <br />