4701 FOREST DR 2020-02-07 - Laserfiche WebLink

PERMIT APPLICATION BUILDING /MECHANICAL/ PLUMBING I SIGN I SPRINKLER/ DEMOLITION !a' CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps(c everettwa.gov 1 www.everettwa.gov/permits t SSW.or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS:4701 FOREST DR PROPERTY TAX#:00449500001500 LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: LINDSAY BAILEY TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: SrREET4701 FOREST DR cnv EVERETT STATE WA ZIP 98203 OWNER PHONE: 360-739-6697 OWNER EMAIL:lindsayjbailey@yahoo,com CONTRACTOR NAME:C.M. HEATING INC CONTRACTOR ADDRESS: STREET 1415 BROADWAY ciTm 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#(REQUIRED): 01609£$ l PRIMARY CONTACT: [DOWNER I]CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:425-259-0550 KAILANA CONTACT EMAIL:KAILANA@CMHEATING.COM BUILDING INFORMATION �Existin• Use of Building Contract Price of Work: $4000 Proposed Use of Building Heat Source: ❑Gas DElectric ❑Other ,� BUILDING USE: OSFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units. _ ❑Commercial ❑Accessory Structure Type of Project New ❑✓Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: SINGLE ZONE DUCTLESS INSTALL PER CONTRACT 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 DryerHeat 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 I Exhaust Hood(Type I) (Not Heat/AC system) Hose Bibb Urinal Exhaust Hood(Type II) Water Heater Interceptor-Grease Waste/Water Piping Repair Exhaust Hood(Residential) Wood Stove Interceptor-Sand/Oil Water Service(behind meter) Forced Air Systems Other: Medical Gas Water Valves or Fixtures Gas Fireplace/InserULog 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: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. k t City of Everett Official Use Only ii' } �// PERMIT# .: /<(<7d1—,</A,'� i / SV 10/16/19 V\R (Q O-� OwnertAuthorized Agent Signature Date (Revised 10/1�f"t0 $) t f