129 112TH ST SE 2020-01-23 - Laserfiche WebLink

41*-77. PERMIT APPLICATION BUILDING! MECHANICAL!PLUMBING / SIGN I 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:129 112TH ST SE PROPERTY TAX#:28042400408700 LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) ^ r- CONTACT INFORMATION OWNER NAME: 1 H C9 SE cei,A 1&L& c 1�W T 1S1NESS NAME(Commercial): OWNER MAILING ADDRESS: sTREEr129 112TH ST SE ` cm( EVERETT STATE WA ZIP 98208 OWNER PHONE: 425-345-8920 OWNER EMAIL:KACERREX@HOTMAIL.COM CONTRACTOR NAME:GS HEATING CONTRACTOR ADDRESS: STREET 3409 EVERETT AVE crry EVERETT STATE WA zp 98201 CONTRACTOR PHONE:425-252-4402 CONTRACTOR EMAIL:MELANIE@GSHEATING.COM CONTRACTOR LICENSE#(REQUIRED):GSH EAHC821 OR CITY OF EVERETT BUSINESS LICENSE#{REQUIRED): 60058 PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR ❑OTHER(P:ease Specify) CONTACT NAME: CONTACT PHONE:425-610-4257 MELANIE MENDENHALL CONTACT EMAIL:MELANIE©GSHEATING.COM BUILDING INFORMATION Existing Use of Building:RESIDENTAIL Contract Price of Work:$11538.33 Proposed Use of Building:RESIDENTAIL Heat Source: ❑Gas Electric ❑Other BUILDING USE: OSFR ❑Townhouse EDuplex ❑ADU ❑Mufti-Family-#Units: ❑Commercial EAccessory Structure Type of Project: ENew EAddition ZRemodel ERepair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition EChange of Use DESCRIPTION OF WORK: HEAT PUMP INSTALLATION ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Fixture Fixture Fixture Fixture Count List of Fixtures Count List of Fixtures Count List of Fixtures Count List of Fixtures A/C—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 1 Heat Pump&Ductless Dishwasher Sink-Residential(kitchen,bath,bar) Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility,laundry,mop Exhaust Fans(Residential) Commercial Ventilatior Floor Drain Toilet Exhaust Hood(Type I) (Not Heat/AC system) Hose Bibb Urinal Exhaust Hood(Type II) Water Heater Interceptor-Grease WastelWater Piping Repair Exhaust Hood(Residential) Wood Stove Interceptor-Sand/OII Water Service(behind meter) Forced Air Systems Other. Medical Gas Water Valves or Fixtures Gas Fireplace/Inse-t/Log Roof Drains Water Heater SPRINKLER/SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other Water Suppression System No.of Heads Chemical Suppression System No.of Heads ACKNOWLEDGEMENT:l 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,l 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 ---17-1717:7-ji7 ,E) , ! ;;i) (.01 1 (9 #cq0 - 0� �. Owner/Authorized Agent Signature Date {Revised 10/10/2018)