Laserfiche WebLink
1 <br /> PERMIT APPLICATION <br /> BUILDING I MECHANICAL/PLUMBING I SIGN/SPRINKLER!DEMOLITION <br /> 04/4104407/.....A CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> , (P)425-257-8510 1 FAX 425-257-8857 1(E)everettePs©everettwa-gov 1 www.eyerettwaloviberalits <br /> hie or Black Ink On i Plealis PROJECT stre INFORRiATION <br /> PROJECT SITE.ADDRESS;406 94TH ST SW PROPERTY TAX#:00726800000100 <br /> LEGAL for new construction: Short sion Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: GENE DAHLIN TENANT BUSINESS NAME(Commercial): <br /> OWNER MAILING ADDRESS: sTREET406 94TH ST SW <br /> CITY EVERETT STATE WA ZIP 98204 <br /> OWNER PHONE: 425-353-0750 OWNER EMAIL:LITTLEDAHLIN©YAHOO.COM <br /> CONTRACTOR NAME:CM. HEATING INC <br /> CONTRACTOR ADDRESS' STREET 1415 BROADWAY <br /> CITY EVERE'TTZIP <br /> STATE WA 98201 <br /> CONTRACTOR PHONE:425-259-0550 CONTRACTOR EMAIL KAI LANA@CMHEATING.COM <br /> CONTRACTOR LICENSE#(REQUIRED):CMHEAI*09554 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 016098 <br /> PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:425-259-0550 <br /> KAI LANA CONTACT EMAIL:KAILANA@CMHEATINGCOM <br /> BUILDING INFORMATION <br /> Existing Use of Building: Contract Price of Work: <br /> Proposed Use of Building; Heat Source: OGas 0Electric 00ther <br /> BUILDING USE OSFR ETownfrouse 0Duplex OADU OMulti-Family-#Units: 111Cominergial ElAccessorY,Sfrucfure ,. <br /> _ <br /> Type of Project ZNew OAddition ORemodel EZ1Repair DTA. D-SiOn EJ4'prfrikter UDeniolitiOn OChange of U$tat , <br /> DESCRIPTION OF WORK: <br /> LIKE IN KIND AIR HANDLER CHANGE OUT WITH HEAT PUMP INSTALLATION <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Fixture Fixture <br /> List of Fixtures Fixture List of Fixtures Fixture List of Fixtures List a Fixtures <br /> NC—Air Handling Units Gas Piping Backflow Preventer(Inside Bldg) Shower,Tub,or Combo <br /> Boiler Gas Range Clothes Washer Sink-Commercial(3-comp,prep,floor) <br /> Clothes Dryer i Heat Pump&Ductless Dishwasher 'Sink-Residential(kitchen,bath,bar) <br /> Duct S stem Remodel Refrit eration Drinking Fountain Sink-Utility,laundry,mop <br /> Man Exhaust Fans(Residential) Commercial Ventilati• Floor Drain Mill Toilet <br /> Exhaust Hood(Type i) (Not Heat/AC system) Hose Bibb Urinal <br /> Exhaust Hood(Type II) Water Heater Interceptor-Grease tfiaste/Water Piping Repair <br /> Exhaust Hood(Residential) Wood Stove intercepter-Band/Oil VVater Service(behind meter) <br /> i Forced Air Systems Other: Medical Gas Water Valves or Fixtures <br /> Gas Fireplace/Insert/Log Roof Drains Water Heater <br /> SPRINIKLEFt i EOPPRERSIOP4 SYSTEFA sewage Ejector or Sump Pump Other: <br /> Water uppression ystem - No of Heads <br /> CfVrfkbf Suppression Sifftr No.of Heads <br /> 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 <br /> current federal,state,and local lawThe 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 property to perform the wont for which application is made, <br /> and I comply with the.ate onfraatora Law 18.27 RCW and 298.200A WAC. <br /> if ..„ City of Everett Official Use Only <br /> V 1 <br /> 12-A3119 VCtli <br /> Owner/A1.101 flied Agent Signature-1 Date (ReMe 10/1 <br />