1421 MADRONA AVE 2019-11-06 - Laserfiche WebLink

#1111111 ir PERMIT APPLICATION � BUILDING I MECHANICAL / PLUMBING I SIGN / SPRINKLER/ DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 1 FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everettwa.govlpermits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS:1421 madrona ave PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision _Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: JUNE BIGELOW TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET 1421 MADRONA AVE cirr EVERETT STATE WA ZIP 98203 OWNER PHONE: 425-870-4998 OWNER EMAIL:Juneb@johnlscott.com CONTRACTOR NAME:C.M. HEATING INC CONTRACTOR ADDRESS: STREET 1415 BROADWAY cin EVERETT STATE WA ZIP 98201 CONTRACTOR PHONE:425-259-0550 CONTRACTOR EMAIL:DEBBIE@CMHEATING.COM CONTRACTOR LICENSE#(REQUIRED):CMHEAI*09554 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 016098 PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:425-259-0550 DEBBIE CONTACT EMAIL:DEBBIE@CMHEATING.COM BUILDING INFORMATION Existing Use of Building: Contract Price of Work:$5100 Proposed Use of Building; Heat Source: 11Gas DElectric DOther BUILDING USE: I:1SFR ❑Townhouse Dlouplex ❑ADU ❑Multi-Famii -#Units: ❑Commercial C{Accessory Structure Type of Project: ❑New ❑Addition ❑Remodel ©Repair ❑T.I. ❑Sian ❑S,prinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: REPLACE GAS FURNACE ASSOCIATED BUILDING PERMIT#(if applicable): I MECHANICAL PERMIT APPLICATION _ PLUMBING PERMIT APPLICATION Fixture List of Fixtures Fixture Fixture Fixture Count Count List of Fixtures Count List of Fixtures Count List of Fixtures A/C—Air Handling Units Gas Piping Backflow Preventer(Inside Bldg) Shower,Tub,or Combo Boiler Gas Range Clothes Washer Sink-Commercial(3-comp,prep,floor) I 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 Ventilation Floor Drain Toilet Exhaust Hood(Type I) (Not Heat/AC system) Hose Bibb Urinal Exhaust Hood(Type II) Water Heater Interceptor-Grease Waste/VVater Piping Repair Exneus:I iu.,d(Residenr ul) Wood Stove Interceptor-Sand/Oil 'Water Service(behind meter) 1 For:.('':Nr ;;isierns Other: Medical Gas Water Valves or Fixtures Gas FIiepl;::c/lnsert/Log Roof Drains Water Heater SPRINKLER l SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other: Wafer Suppression System No.of Heads Chemical Suppres mri,wstem 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,stale,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,orf am authorized by the owner of this property to perform the work for which application is made, and!comply with the Stale Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT rry,\ \61 )1 .......,,,i,,:: ,yit lg jrro Date (Revised 10/10,2018) 1