1914 RAINIER AVE 2019-09-24 - Laserfiche WebLink

MIN PERMIT APPLICATION BUILDING ( MECHANICAL/ PLUMBING /SIGN /SPRINKLER/ DEMOLITION E V E R E T TCITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 WASHINGTON (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: 1914 RAINIER AVE PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: DORTHEY THOMPSON TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET 1914 RAINIER AVE CITY EVERETT STATE ZIP 98201 OWNER PHONE:425-252-6450 OWNER EMAIL: CONTRACTOR NAME: HAMBLEN & SONS HEATING CONTRACTOR ADDRESS: STREET 7409 68TH AVE NE CITY MARYSVILLE STATE WA ZIP 98270 CONTRACTOR PHONE: 425-501-0123 CONTRACTOR EMAIL: HAMBLEN.SONS@GMAIL.COM CONTRACTOR LICENSE#(REQUIRED): HAMBLSH922DE CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 053666 PRIMARY CONTACT: ❑OWNER EI CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 425-501-0123 TIM CONTACT EMAIL:HAMBLEN.SONS@GMAIL.COM BUILDING INFORMATION Existing Use of Building: Contract Price of Work: $400 Proposed Use of Building: Heat Source: OGas DElectric DOther BUILDING USE: DSFR ❑Townhouse EDuplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure Type of Project: ❑New ❑✓Addition ❑Remodel El Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: Extend gas line—5'to range ASSOCIATED BUILDING PERMIT#(if applicable): 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 1 Gas Piping Backflow Preventer(Inside Bldg) Shower,Tub,or Combo Boiler Gas Range Clothes Washer Sink-Commercial(3-comp,prep,floor) Clothes Dryer 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) Forced Air Systems Other Medical Gas Water Valves or Fixtures Gas Fireplace/Insert/Log Roof Drains Water Heater SPRINKLER/"SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other: Water Suppression System No.of Heads Chemical Suppression System No.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 th State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only 9/9/19 PET pk/��([`18 /� I I (Revised ner/Authorized Agent Signature Date10/-10A0 I