4925 23RD AVE W 2019-09-18 - Laserfiche WebLink

I F PERMIT APPLICATION BUILDING / MECHANICAL/ PLUMBING /SIGN /SPRINKLER/ DEMOLITION CITY OF EVERETT PERMIT SERVICES via 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 i FAX 425-257-8857 1(E)everetteps@everettwa.gov 1 www.everettwa.govlpermits (Blas or Black Ink Only Plrsso) PROJECT SITE INFORMATION A PROJECT SITE ADDRESS:4925 23RD AVE W PROPERTY TAX#:00644500002400 a LEGAL for new construction: Short Plat/subdivision Lot No_ (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: JOHN WEST TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: sTREET4925 23RD AVE W CiTv EVERETT STATE WA ZIP 98203 OWNER PHONE: 425-328-4508 OWNER EMAIL:johnrandallwest@gmail.com CONTRACTOR NAME:C.M. HEATING INC CONTRACTOR ADDRESS: STREET 1415 BROADWAY ciTv EVERETT STATE WA zip 98201 CONTRACTOR PHONE:425-259-0550 CONTRACTOR EMAIL:KAILANA@CMHEATING.COM CONTRACTOR LICENSE#(REQUIRED):CMHEAI*09554 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 016095 PRIMARY CONTACT: ❑OWNER El CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:425-259-0550 KAILANA CONTACT EMAIL:KAILANA@CMHEATING.COM BUILDING INFORMATION Existing Use of Building: Contract Price of Work:$10850 Proposed Use of Building: Heat Source: ❑Gas DElectric ❑Other.. BUILDING USE: OSFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units. ❑Commercial ❑Accessory Structure Type of Project: ❑New ❑Addition ❑Retnodel DRepa€r ❑T.I. ❑Sign LJSpr)nkler ❑Demolition EChange of Use DESCRIPTION OF WORK: LIKE IN KIND AIR HANDLER AND HEAT PUMP REPLACEMENT ASSOCIATED BUILDING PERMIT#(if applicable); t' MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Fixture Fixture Fixture Fixture Count List of Fixtures Count List of Fixtures Count List of Fixtures Count List of Fixtures . NC—Air Handling Units Gas Piping Backflow Preventer(Inside Bldg) Shower,Tub,or Combo Boiler Gas Range _ Clothes Washer Sink-Commercial(3-comp,prep,floor)• . Clothes Dryer r Heat Pump&Ductless Dishwasher Sink-Residential(kitchen,bath,bar) Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility,laundry,mop Exhaust Fans(Residential) Commercial Ventilatior Floor Drain Toilet Exhaust Hood(Type I) (Not Heat/AC system) Hose Bibb Urinal Exhaust Hood(Type II) Water Heater Interceptor-Grease Waste/Water Piping Repair Exhaust Hood(Residential). Wood Stove Interceptor-Sand/Oil Water Service(behind meter) _ I Forced Air Systems Other: Medical Gas Water Valves or Fixtures Gas Fireplace/Insert/Log Roof Drains Water Heater w; SPRINKLER/SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other: '',Water Suppression System INo.of Heads Chemical Suppression System 1 iNo.of Heads ;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 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 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` and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only J PER /4l-1iL4 /r/C/V 08/06/15 T# l\�O ® O \ ( Owner/Authorized Agent Signature Date (Revised(8/10:201.8) i d