5023 10TH PL W 2021-02-23 - Laserfiche WebLink

• • PERMIT APPLICATION 1 #IIIPfr BUILDING I MECHANICAL/ PLUMBING /SIGN /SPRINKLER/ DEMOLITION 1 CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa,gov I www.everettwa.gov/permits (Blau.or Blank Ink Only Ply) PROJECT'.SITE INFORMATION PROJECT SITE ADDRESS:5023 10TH PL W PROPERTY TAX#:00566400000300 LEGAL for new construction: Short Plat/subdivision Lot Na__ (attach copy of long legal description) C CONTACT INFORMATION : OWNER NAME: DIANE CAMPBELL TENANT BUSINESS NAME(Commercial); OWNER MAILING ADDRESS: STREET 5023 10TH PL W ciT- EVERETT STATE WA ZIP 98203 OWit NER PHONE: 425-319-1743 'OWNER EMAIL:N/A t CONTRACTOR NAME:C.M. HEATING INC CONTRACTOR ADDRESS: STREET 1415 BROADWAY el-ry 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): 016098 PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:425-259-0550 KAI LANA CONTACT EMAIL:KAILANA c©DCMHEATING.COM BUILDING INFORMATION Existing Use of Building. Contract Price of Work:g 1s,aoo Proposed Use of Building: Heat Source: OGas DElectric DOther BUILDING USE: OSFR ETownhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure Type of Project: ©New IZZlAdditlon ❑Remodel ZRepair ❑T,I LiSign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: LIKE IN KIND GAS FURNACE CHANGE OUT WITH HEAT PUMP INSTALLATION 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 Dryer t 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) 1 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 �No.offleads Chemical Suppression System INo.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 F 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, ,I and I comply with the State Contractors Law 18.27 RCW and 296.200A WAG. City of Everett Official Use Only PER I # i,• !. i V-Z-.t .fit/ 1 il04/c l/ 08/22/19 D 0 Owner/Authorized Agent Signature Date (Revised 70/90t,2Of8)