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PERMIT APPLICATION <br /> BUILDING!MECHANICAL!PLUMBING!SIGN!SPRINKLER!DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> • <br /> (P)425-257-881.0 I FAX 425-257-8857 1(E)everettepsleverettwa.gov I www.everettwa.govlpermits <br /> (Blue or Black ink Only r Plus* PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS:529 94TH ST SW PROPERTY TAX#:00726800001100 <br /> LEGAL for new construction: Short Plat/subdivision Lot No (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: MICHAEL STEWART TENANT BUSINESS NAME((Commercial): <br /> OWNER MAILING ADDRESS: STREET 529 94TH ST SW <br /> ciTY EVERETT STATE WA ZIP 98204 <br /> OWNER PHONE:425-290-8044 OWNER EMAIL:rnstewart28©fastmail,Com <br /> CONTRACTOR NAME:C.M. HEATING INC <br /> CONTRACTOR ADDRESS: STREET 1415 BROADWAY <br /> CITY EVERETT STATE WA ziP.98201 <br /> CONTRACTOR PHONE:425-259-0550 CONTRACTOR EMAIL:KAILANA@CMHEATING.COM <br /> CONTRACTOR LICENSE#(REQUIRED)CMHEAI*09554 crry OF EVERETT BUSINESS LICENSE*(REOLTIRRD). 016098 <br /> II--__A, <br /> PRIMARY CONTACT: D OWNER ID CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: ,CONTACT PHONE:425-259-0550 <br /> KAiLANA IQ GMS�El�►TINCs.0 OM CONTACT EMAIL:KAILAIVA@CNIHEATIAIG.COM <br /> BUILDING•INFORMATION <br /> .Existing Use of Building: Contract Price of Work:$;9 w <br /> Proposed Use of Budding: CHeat Source: OGas DElectric DOther <br /> . UIL ING USE: DSFR ['Townhouse ❑Duplex ❑ADU ❑MUlti-Fa t jY-#Units: ❑Commercial 0A000SSOry Structure <br /> °hype of Project: ['New ©Addition ©Remodel ❑Repair ❑T,l., ❑Sign pttnkler ['Demolition l hange of Use <br /> DESCRIPTION'OF WORK: 2 ZONE DUCTLESS INSTALL <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL.PERMIT APPLICATION PLUMBING PERMIT APPLIICATION <br /> FixtureFrxeuro Fixture Fixture <br /> Count List of Fixtures count List of Fixtures Count List of Fixtures Count Ust of Fixtures <br /> rr <br /> _ .. <br /> NC—Air Handling Units Gas Piping Backflow Preventer 2inside Bl ) Shower,Tub,or Combo <br /> Soder Gas Range Clothes Washer Sink-Commercial(3-comp,prep,floor) <br /> Clothes Dryer t 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 It) 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 4.1., Water Heater <br /> SPRINKL1eR 1 SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other: <br /> ' ater:suppression System` ' o,of'1:teads <br /> Chemical suppression system J No.of Heads <br /> ACKNOWLEDGEMENT:t 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 lam the owner,or lam authorized by the owner of this properly to perform the work for which application is made, <br /> and I comply with the State Contractors Law 18.27 RCW and 296.200A WAG. <br /> City of Everett Official Use•Or ly' <br /> PMktek or4... ..... <br /> 4 <br /> / r./14_/'A/4/.4 Zit/).4/1 07/11i19 \ <br /> Owner/Authorized A nt"Si nature Date 5 <br /> 9e 9 __ (fa''9vtdteet;lEt?r�t�1'.t7J. <br />