3821 SHORE AVE 2019-11-07 - Laserfiche WebLink

PERMIT APPLICATION /"' BUILDING / MECHANICAL/ PLUMBING /SIGN /SPRINKLER/ DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I w w.evereftwa.govtpermits (Blue or Black Ink Only Pleas') PROJECT SITE INFORMATION PROJECT SITE ADDRESS:3821 SHORE AVE _PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision, Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: DOUGLAS HADLEY TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET3821 SHORE AVE crrr EVERETT STATE WA ZIP 98203 OWNER PHONE: 425-3448-7218 OWNER EMAIL: CONTRACTOR NAME:C.M. HEATING INC CONTRACTOR ADDRESS: STREET 1415 BROADWAY . cin, EVERETTSTATE 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 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:425-259-0550 DEBBIE CONTACT EMAIL:DEBBIE@CMHEATING.COM BUILDING INFORMATION Existing Use of Building:SFR Contract Price of Work:$ "il5o•0 M Proposed Use of Building: Heat Source: ❑Gas pttlectric ❑Other, BUILDING USE: OSFR ❑Townhouse [Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.l. ElSi.on OSprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: INSTALL HEAT PUMP AND AIR HANDLER , ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Flxrure Fixture Fixture Fixture Count List of Fixtures 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 WSink-Commercial(3-comp,prep,floor) Clothes Dryer _ 1 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) 1 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.on:leads Suppression System No.of Heads ACKNOWLEDGEMENT:I have reviewed this application and conlinn 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 296.200,4 WAC. I Cityof Everett Official Use Only � L- 1 8 .19 -15I ` PERM # DiJD 1 ,OwneriA thorized Agent S n ture (� Date ( (Revised 10/10/2018) ' I e