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PERMIT APPLICATIOII <br /> MIll <br /> BUILDING i I1nECHANICAL / PLUMBING / SIGN i .SPRINKLER / DEMOLITION <br /> E V E R E T TCITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> WASHINGTON (P)425-257-8810 I FAX 425-257-8857 I (E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: 1 10-) — t G ci'` 5k �s C,,_,...�-., -'rt PROPERTY TAX#:oc,t.. 8 0(,,00 L c -Z I OS <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Joyce Nicol TENANT BUSINESS NAME(Commercial): <br /> OWNER MAILING ADDRESS: STREET 1907 - 100th St. SW <br /> CIT. Everett STATE WA ZIP 98204 <br /> OWNER PHONE: 425-353-0844 OWNER EMAIL: <br /> CONTRACTOR NAME: Kalmey Heating <br /> CONTRACTOR ADDRESS: STREET 9025 W. Meadow Lake Drive <br /> CITY Snohomish STATE WA 7IP 98290 <br /> CONTRACTOR PHONE: 360-568-0162 CONTRACTOR EMAIL: Lisakalmey@aol.com <br /> CONTRACTOR LICENSE#(REQUIRED): KALMEH*066PD CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 032304 <br /> PRIMARY CONTACT: D OWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 425-353-0844 <br /> Joyce Nicol CONTACT EMAIL: <br /> BUILDING INFORMATION <br /> Existing Use of Building: Contract Price of Work: $ 7000.00 <br /> Proposed Use of Building: Heat Source: OGas ❑Electric ❑Other <br /> BUILDING USE: OSFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units:_ ❑Commercial ❑Accessory Structure <br /> Type of Project: ❑New ❑Addition ❑Remodel ❑✓Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: <br /> Remove and replace gas furnace. <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Fixture Fixture Fixture Fixture <br /> Count List of Fixtures Count List of Fixtures Count List of Fixtures Count List of Fixtures <br /> A/C—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 Heat Pump&Ductless Dishwasher Sink-Residential(kitchen,bath,bar) <br /> Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility,laundry,mop <br /> Exhaust Fans(Residential) Commercial Ventilation Floor Drain Toilet <br /> Exhaust Hood(Type I) (Not Heat/AC system) Hose Bibb Urinal <br /> Exhaust Hood(Type II) Water Heater Interceptor-Grease Waste/Water Piping Repair <br /> Exhaust Hood(Residential) Wood Stove Interceptor-Sand/Oil Water Service(behind meter) <br /> 1 Forced Air Systems Other: Medical Gas Water Valves or Fixtures <br /> Gas Fireplace/Insert/Log Roof Drains Water Heater <br /> SPRINKLER/ SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other: <br /> Water Suppression System No.of Heads <br /> Chemical Suppression System 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 law. The 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. I am the owner, or I am authorized by the owner of this property to perform the work for which application is made, <br /> and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> Owner! uthorized Agent Signatur Date (Revised 10/10/2018) <br />