3213 56TH ST SW 2019-11-15 - Laserfiche WebLink

OLT 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 www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS:3213 56th ST SW PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: STACIE BACON TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: sTREET3213 56TH ST SW CITY EVERETT STATE WA ZIP 98203 OWNER PHONE: 703-399-0517 OWNER EMAIL: CONTRACTOR NAME:C.M. HEATING INC CONTRACTOR ADDRESS: STREET 1415 BROADWAY cIT 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 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:425-259-0550 DEBBIE CONTACT EMAIL:DEBBIE@CMHEATING.COM BUILDING INFORMATION Existing Use of Building.SF Contract Price of Work: $ t o • o/ �J Proposed Use of Building: Heat Source: IZGas ElElectric ❑Other BUILDING USE: ❑v SFR Townhouse ❑Duplex EADU ❑Multi-Family-#Units: ECommercial ❑Accessory Structure Type of Project: ❑New ❑Addition ❑Remodel ZRepair ❑T.l. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: REPLACE LIKE FOR LIKE GAS WATER HEATER ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Fixture Fixture Fixture Fixture Count List of Fixtures coon: 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 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/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 _ ater ieatec. 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 the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT O(8- Debbie Bauers oyaairy srenea By Den.Bauers oate.sols oe is oenas aroo8/15/19 I Owner/Authorized Agent Signature Date (Revised 10/10/2018)