1722 VIRGINIA AVE 2020-04-02 - Laserfiche WebLink

4rErr PERMIT APPLICATION BUILDING 1 MECHANICAL/PLUMBING/SiGN/SPRINKLER/DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 1 FAX 425-257-8857 1(E)everetteps@everettwa.gov f www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITEADDRESS: VIRGINIA AVE PROPERTY TAX#: 00438835402100 LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: JAN MCCULLOCH TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET 1722 VIRGINIA AVE cmr EVERETT STATE WA zip 98201 OWNER PHONE: 509-699-0275 OWNER EMAIL;JMCCULLOCH555@GMAIL.COM CONTRACTOR NAME:GS HEATING CONTRACTOR ADDRESS: STREET 3409 EVERETT AVE cnY EVERETT STATE WA zip 98201 CONTRACTOR PHONE:425-810-4257 CONTRACTOR EMAIL:MELANIE@GSHEATING.COM CONTRACTOR LICENSE#(REQUIRED);GSHEAHC821 QR CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 60058 PRIMARY CONTACT: 0 OWNER Q CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME; CONTACT PHONE:425-610-4257 MELANIE MENDENHAL CONTACT EMAIL:MELANIE@GSHEATING.COM BUILDING INFORMATION Existing Use of Building:RESIDENTAIL Contract Price of Work:$$12126.33 Proposed Use of Building:RESIDENTAIL Heat Source: OGas ❑Electric ❑Other BUILDING USE: DSFR ❑Townhouse ❑Duplex EADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure Type of Project: :New ❑Addition IZIRemodel ❑Repair ❑T.i. ❑Sign OSprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: INSTALLATION OF A DUCTLESS SYSTEM 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 AIC—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 Ventilatior Floor Drain Toilet 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/Insert/Log Roof Drains Water Heater SPRINKLER/SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other. Water Suppression System f No.of Heads Chemical Suppression System I Na.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.l am the owner,or 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 16.27 RCW and 296,200A WAC. City of Everett Official Use Only PEWea (_10-Lcio Owner/Auth rize0.Age Signature . Date (Revised 10/10/2016)