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5021 OCEAN AVE 2019-11-14
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5021 OCEAN AVE 2019-11-14
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11/14/2019 2:18:49 PM
Creation date
11/14/2019 2:18:33 PM
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Address Document
Street Name
OCEAN AVE
Street Number
5021
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46-77* PERMIT APPLICATIO.. <br /> BUILDING / MECHANICAL / PLUMBING / SIGN / SPRINKLER / DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 1 (E)everetteps@everettwa.gov 1 www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS:5021 OCEAN AVE PROPERTY TAX#:29043400401000 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: MICHAEL BETTS TENANT BUSINESS NAME(Commercial): <br /> OWNER MAILING ADDRESS: STREET 5021 OCEAN AVE <br /> crn EVERETT STATE WA ZIP 98203 <br /> OWNER PHONE: 425-355-6041 OWNER EMAIL:Bettsea2252@comcast.net <br /> CONTRACTOR NAME:C.M. HEATING INC <br /> CONTRACTOR ADDRESS: STREET 1415 BROADWAY <br /> civ EVERETT STATE WA z,P 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: ❑OWNER 0 CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:425-259-0550 <br /> KAILANA CONTACT EMAIL:KAILANA@CMHEATING.COM <br /> BUILDING INFORMATION 4 <br /> Existing Use of Building: Contract Price of Work: $5250 <br /> Proposed Use of Building: Heat Source: ❑Gas ❑Electric DOther <br /> BUILDING USE: ❑D SFR Townhouse ilDuplex ❑ADU ❑Multi-Family-#Units: DCommercial ❑Accessory Structure <br /> Type of Project: ❑New ❑Addition ✓Remodel (Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: <br /> LIKE IN KIND GAS FURNACE CHANGE OUT <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Fixture Fixture Fixture Fixture <br /> Count List of Fixtures count List of Fixtures Count List of Fixtures Count List of Fixtures <br /> A/C—Air Handling Units Gas Piping Backflow Preventer(Inside Bldg) Shower,Tub,or Combo <br /> Boiler Gas Range Clothes Washer Sink-Commercial(3-comp,prep,floor) <br /> Clothes Dryer Heat Pump&Ductless Dishwasher Sink-Residential(kitchen,bath,bar) <br /> Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility, laundry, mop <br /> Exhaust Fans(Residential) Commercial Ventilation Floor Drain Toilet <br /> Exhaust Hood(Type I) (Not Heat/AC system) Hose Bibb Urinal <br /> Exhaust Hood(Type II) Water Heater Interceptor-Grease Waste/Water Piping Repair <br /> Exhaust Hood(Residential) Wood Stove Interceptor-Sand/Oil Water Service(behind meter) <br /> 1 Forced Air Systems Other: Medical Gas Water Valves or Fixtures <br /> Gas Fireplace/Insert/Log Roof Drains Water Heater <br /> SPRINKLER/ SUPPRESSION SYSTEM, Sewage Ejector or Sump Pump Other: <br /> Water Suppression System No. of Heads <br /> Chemical Suppression System No.of Heads <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, <br /> and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> /J �J /J PERMIT# <br /> t cIL Y/t9 Y 77710/%1 10/04/19 r(A. 0 ' 02-,LC <br /> Owner/Authorized Agent Signature Date (Revised 10/10/2018) <br />
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