216 MADISON ST 2020-01-30 - Laserfiche WebLink

"I" PERMIT APPLICATIO4 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 1(E)everetteps(geverettwa.gov I www.everettwa.gov/permits PROJECT SITE ADDRESS:216 MADISON ST PROPERTY TAX#:00392000000109 LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) OWNER NAME: BETH CALSYN TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: sTREET216 MADISON ST crry EVERETT STATE WA zip 98203 OWNER PHONE: 425-387-6065 OWNER EMAIL:bethSimmons44@gmail.Com CONTRACTOR NAME:C.M. HEATING INC CONTRACTOR ADDRESS: STREET 1415 BROADWAY CIT, EVERETT STATE WA ZIP 98201 CONTRACTOR PHONE:425-259-0550 CONTRACTOR EMAIL:KAILANA@CMHEATING.COM CONTRACTOR LICENSE#(REQUIRED):CMHEAI*09554 CITY OF EVERETT BUSINESS LICENSE . 016098 PRIMARY CONTACT: 0 OWNER D CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:425-259-0550 KAI LANA CONTACT EMAIL:KAILANA@ TING.COM Existing Use of Building: Contract Price of W•rk:$9500 Proposed Use of Building: Heat Source: DGa ❑EI- tric ❑Other BUILDING USE: DSFR ETownhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: aCommercial ❑Accessory Structure Type of Project: ❑New ❑Addition ©Remodel ©Repair ❑T.I. ❑Sign ❑Sprinkler EDemolition ❑Change of Use DESCRIPTION OF WORK: LIKE IN KIND GAS FURNACE CHANGE OUT WITH 40 GALLON GAS HWT REPLACEMENT ASSOCIATED BUILDING PERMIT#(if applicable):R HANIIcAA* ,,, FixtureHxture 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 —Heat Pump&Ductless —Dishwasher —Sink-Residential(kitchen,bath,bar) Duct System(Remodel) —Refrigeration —Drinking Fountain —Sink-Utility,laundry,mop Exhaust Fans(Residential) Commercial Ventilatio —Floor Drain —Toilet Exhaust Hood(Type I) (Not Heat/AC system) —Hose Bibb —Urinal Exhaust Hood(Type II) 1 Water Heater —Interceptor-Grease —Waste/Water Piping Repair Exhaust Hood(Residential)_Wood Stove —Interceptor-Sand/Oil —Water Service(behind meter) 1 Forced Air Systems —Other: _Medical Gas —Water Valves or Fixtures Gas Fireplace/Insert/Log —Roof Drains _Water Heater 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 -100041C1 07/29/19 P_R(II�� ^ ?: L( Owner/Authorized Agent Signature Date (Revised 10/10/2018)