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PERMIT APPLICATION
<br /> BUILDING/MECHANICAL/PLUMBING/SIGN I SPRINKLER I DEMOLITION
<br /> CITY OF EVERETT PERMIT SERVICES
<br /> 3200 CEDAR STREET,EVERETT,WA 98201
<br /> (P)425-257-8810 1 FAX 425-257-8857 1(E)everetteps@everettwa gov I www.everettwa.gov/permits
<br /> iBlyior iBlitekInk Q>nly Rowe). PROJECT SI'fR Si ,ORMATIO.N ,
<br /> PROJECT SITE ADDRESS:7529 RAINIER DR PROPERTY TAx#:.00394000007.100
<br /> LEGAL for new construction Short,Plat/subdivision Lot'No. (attach copy of long legal description)
<br /> ° CONTAC INFORMATION
<br /> OWNER NAME: DAVID BRANDVOLD TENANT BUSINESS NAME(Commercial):
<br /> OWNER MAILING ADDRESS: arREEr7529 RAINIER DR
<br /> ciryEVERETT STATE WA zip 98203
<br /> OWNER PHONE: 425-353-3952
<br /> OWNER EMAIL:KAILANA@CMHEATING.GOM
<br /> CONTRACTOR NAME:C.M. HEATING INC
<br /> CONTRACTOR ADDRESS: STREET 1415 BROADWAY
<br /> CITY EVERETT STATE..WA 98201
<br /> .., r:. . d. .., ,,, — ,,..,,,, '-TFT 'I("S/.l ':i/( i. •1'.. .,,.,. `S`" ..."' ,.11 "
<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: 0 OWNER 0 CONTRACTL. OR 0 OTHER(Please Specify) . "'
<br /> CONTACT NAME: CONTACT PHONE:425-259-0550 '`,,
<br /> AI LANA CONTACT EMAIL:KAILANA@CMHEATING.COM
<br /> BU$1.DINC INFORMAT,(0 L.
<br /> Existin• Use of Buildln•: Contract Price of Work:$5000 vWN YvW mmti ^
<br /> PrO osod Use of Sullding:• Heat Source: OGas 0Electric OOtlier ,":
<br /> BUILDING USE....I ISFR ❑Townhouse (Duplex OADU OMUUItf-Family-#Units: QCommercial DAccessor Structure
<br /> Type of Project. ©New ©Addition .0 Remodel, °R air DTI. C ISigti OSprinkier ❑Demolition DChatn$e of Use
<br /> DESCRIPTION OF WORK:,
<br /> SINGLE ZONE DUCTLESS INSTALL ' ;
<br /> 'ASSOCIATED BUILDING PERMIT#,if applicable);
<br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION
<br /> 1 Fixture Fixture Fixture Fixture
<br /> Count List of Fixtures count List of Fixtures List of Fixtures List of Fixtures
<br /> x
<br /> Count Count
<br /> NC—Air Handling Units Gas Piping Backflow Preventer(Inside Bldg) Shower,Tub,or Combo
<br /> Boiler Gas Range 4 4 Clothes Washer Sink-Commercial(3-comp,prep,floor):"
<br /> Clothes Dryer • i Heat Pump&Ductless Dishwasher ... ( )... �.''..
<br /> Sink-Residential kltchen,bath,bar
<br /> Duct System(Remodel)__. Refrigeration Drinking Fountain Sink-Utility,laundry,mop:
<br /> Exhaust Fans Residential) Commercial Ventilatio Floor Drain .Toilet „,
<br /> Exhaust Hood T}Yj?e 1
<br /> �..� ) : (Not Nea#lAC-system) , Hose Bibb '� Urinal "`
<br /> Exhaust Hood;(Ty•e II) Water.Heater Interceptor-Grease -- Waste/NaterPiping 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/InsertLog ; Roof Drains Water Heater
<br /> SPRINKLER./; ,UPPRESSION SYSTEM Sewage"Ejectcr or Sump Pump Other
<br /> 7vatecs>;1p feSSll7ri 5€en'i lo.of Heads
<br /> bmca ppressen.Sy=,=Tri �o.o `ea•s ,
<br /> ClfiVOWLI=D elvf$NT 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 /> lrrrett 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 /> ulWing 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
<br /> nd!comply with the State Contractors Law 18.27 RCW and 298.200A WAC.
<br /> 'City of Everett Official,Use Only" 17
<br /> PER li — tip14:461444,14./ W? 10/30/19
<br /> .0-W4eri,Authedied AgentSignature Date
<br /> (Rev sect./Oil 0120.tt) •
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