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PERMIT APPLICATION <br /> elPySe"---._ BUILDING I MECHANICAL/ PLUMBING/SIGN /SPRINKLER I DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> vtiliri <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.govfpermits <br /> (Biu•or Black Ink Only Pions.) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS:1001 W CASINO RD UNIT E-103 PROPERTY TAX#:00856600510300 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: AMANDA CLAPPER TENANT BUSINESS NAME(Commercial): <br /> OWNER MAILING ADDRESS: STREET 1001 W CASINO RD UNiT E-103 <br /> CITY EVERETT STATE WA ZIP 98204 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME:C.M. HEATING INC <br /> CONTRACTOR ADDRESS: STREET 1415 BROADWAY <br /> cin EVERETT STATE WA zip 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: El OWNER El CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:425-259-0550 <br /> CAI LANA CONTACT EMAIL:KAILANA@CMHEATING.COM <br /> BUILDING INFORMATION 71 <br /> ,Existing Use of Building. —Contract Price of Work:$4000 <br /> Proposed Use of Building: Heat Source: OGas DElectric ❑Other <br /> BUILDING USE: EISFR ElTownhouse ❑Duplex EJADU ❑Multi-Farnily-#Units: , ©Commercial ❑Accessory Structure <br /> Type of Project CINew [LiAddition ❑Remodel HRepair DT.I. ['Sign ❑Sprinkler ❑Demolition DChange of Use <br /> DESCRIPTION OF WORK: <br /> LSINGLE ZONE DUCTLESS INSTALLATION <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> " Fixture Fixturo Fixture Fixture <br /> Count List of Fixtures Count List of Fixtures Count List of Fixtures CountList of Fixtures <br /> AIC—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 I 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 Ventilator 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 /> Forced Air Systems Other: Medical Gas Water Valves or Fixtures <br /> Gas Fireplace/Insert/Log Roof Drains Water Heater <br /> SPRINKLER I 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 end 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.f am the owner,or l am authorized by the owner of this property to perform the work for which application is made, <br /> and l comply with the State Contractors Law 18,27 RCW and 296 200A WAG <br /> City of Everett Official Use Only <br /> l ;rciC 1 410/7 ( 09/20/19 \ `Iffff v 1 r O <br /> Owner/Authorized Agent Signature Date (Revised 10/10/2018} <br /> T <br />