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PERMIT APPLICATION <br /> BUILDING/MECHANICAL/ PLUMBING I SIGN I SPRINKLER/DEMOLITION <br /> Notic.iCITY OF EVERETT PERMIT SERVICES <br /> ' 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I(E)everettepsataverettwa.govi www.everettwa.gov/permits <br /> Pilitli.lamrgilfillnk ttNroit :. <br /> PROJECT SITE 2„5 A ,-s--. PROPERTY TAX#: <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> !*': ' ,i•'4 \c4f/CONTA ATI ON ; .. !" <br /> OWNER NAME: WILLIAM MARTIN TENANT BUSINESS NAME(Commercial): <br /> OWNER MAILING ADDRESS: STREET425 ALDER ST <br /> crry EVERETT STATE WA zip 98203 <br /> OWNER PHONE: 425-268-7374 'OWNER EMAiL:bifhecougar'nUU@}f1.ott: JfrC <br /> CONTRACTOR NAME:C.M. HEATING INC <br /> CONTRACTOR ADDRESS: STREET 1415 BROADWAY w <br /> r <br /> CITY EVERETT STATE WA ZIP 98201 `° <br /> . <br /> CONTRACTOR PHONE:425-259-0550 CONTRACTOR EMAIL:KAILANA@CMHEATING.COM '"M <br /> CONTRACTOR•LICENSE*REQUIRED):CMHEAI*09554 CITY OF EVERETT BUSINESS LICENSE#(REQUIREf): 016098 <br /> a. . ,. ..x_. .w .r <br /> .PRIMARY CONTACT: ❑OWNER D CONTRACTOR 0 OTHER(Please Specify) -, <br /> Q ., <br /> CONTACT NAME: CONTACT PHONE:425-259-0550 '.. <br /> -KA ILANA CONTACT EMAIL:KAILANA@CMHEATING.COM . <br /> �� ,4N,V.���'•..k... _ ...✓,.,,'')41,,,„4,:k 4.tt%T� iI#UiLiiaiiiiNrtoriII)lAott.•y \ .,_.� z&�'�x��.,` . \���\�,,y :. 5..,1 ;+ <br /> Existing Use of Building., Contract Price of Work:$10400 <br /> Proposed Use of Building: )Heat Source: ❑Gas ❑Electric ❑Other <br /> ,r <br /> BUILDING USE: DSFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units:,,,_, ❑Commercial ❑Accessory Structure <br /> Type of Project: ONew DAddition ©Remodel ©Repair DTI. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use, <br /> DESCRIPTIONOFWORK: LIKE IN KIND FURNACE CHANGE OUT WITH HEAT PUMP INSTALLATION --s" <br /> ASSOCIATED BUILDING PERMIT#Sit agplicabwe)t r. ., NC—Air Handlin• Units Gas Pk i • Backflow Preventer Inside Bld• Shower <br /> ',1,44 lmkeliANIcACoglevillr•APPLICAllok 4 Ric: '''Cr';',f''''14`''',lc o'''!i;AIRLAPIMOIN cl;I:::7,7APPLIICATIO_1::Arit'''" .. <br /> 'Fixture Fixture Fixture Fixture <br /> Ust of Fixtures Ust of Fixtures Ust of Fixtures List of Fixtures . <br /> 7 Count count Count Count — <br /> . or Combo <br /> Boiler Gas Range Clothes Washer Sink-Commercial(3-comp,prep,floor) <br /> Clothes Dryer i Heat Pump&Ductless Dishwasher Sink-Residential(kitchen,bath,bar) <br /> Duct System(Remodel) Refrigeration Drinkin;Fountain Sink-Utility,laundry,mop <br /> Exhaust Fans Residential: Commercial Ventilatio 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 /> RSP "-f. i RE$$ ON YS1EM n .; . Sewage Ejector or Sump Pump Other <br /> ater tuppression System ' °.of Heads <br /> Chemical Suppression System I No.ofHeads <br /> .4010/t?tNt.EDOE 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 /> :am*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 /> uilding Official before being authorized under any circumstance.lam the owner,or I am authorized by the owner of this property to perform the work for which application is made,, <br /> nd i comply with the State Contractors Law 18.27 RCW and 298.200A WAC. <br /> of Everett Official Use Only: <br /> PERMI <br /> r 71, , 06/13/19h \R nCf D <br /> 4& ... <br /> ,.. <br /> Owner/Authorized Agent Signature Date (RdvtSed/0/1012063) <br />