Laserfiche WebLink
0 • <br />PERMIT APPLICATION <br />BUILDING / MECHANICAL / PLUMBING 1 SIGN / SPRINKLER / DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />(P) 425-257-8610 1 FAX 425-257-8857 j (E) everetteps@ieverettwa.gov I vAvw.evereltwa,govipermits <br />131uo or Black Ink Only Pl w PROJECT SITE INFORMATION <br />PROJECT SITE ADDRESS:4815 COLBY AVE <br />1PROPERTY TAX #: 29053100400700 <br />LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br />CONTACT INFORMATION <br />OWNER NAME: BEN DANIELS TENANT BUSINESS NAME (Commercial): <br />OWNER MAILING ADDRESS: STREET4815 COLBY AVE <br />cnv EVERETT STATE WA zip 98203 <br />OWNER PHONE: 425-417-2010 <br />OWNER EMAIL: ben@benandcarly.com <br />CONTRACTOR NAME: C.M. HEATING INC <br />CONTRACTOR ADDRESS: STREET 1415 BROADWAY <br />cin, EVERETT STATE WA ZIP 98201 <br />6' F' <br />cONTRACTOR PHONE:425-259-0550 <br />CONTRACTOR EMAIL: KAILANA@CMHEATING.COM <br />MONTRACTOR LICENSE #(REQUIRED): CMHEAI"09554 <br />CITY OF EVERETT BUSINESS LICENSE #(REQUIRED): 01609,8r. <br />PRIMARY CONTACT: ❑ OWNER O CONTRACTOR ❑ OTHER (Please Specify) <br />CONTACT NAME: <br />KAI LANA <br />CONTACT PHONE:425-259-0550 <br />CONTACT EMAIL: KAILANA c@CMHEATING,COM <br />BUILDING INFORMATION <br />Existing Use of Building: <br />Contract Price of Work: $ 17,000 <br />Proposed Use of building: <br />Heat Source: E]Gas ElElectric ❑Other <br />BUILDING USE: CISFR ❑Townhouse ❑Du lex ❑ADU ❑Multi -Family- # Units: ❑Commercial DAccessory Structure <br />Type of Project ©New ©Addition ©Remodel ZIRe air ❑T.I. ❑Sin ❑S rinkler ❑Demolition ❑Chan a of Use <br />IDEwSCRIPTION OF WORK: <br />,,GAS FURNACE INSTALLATION WITH A/C ADD ON AND GAS PIPING TO TANKLESS WATER HEATER, FURNACE AND <br />'STUBBING OFF FOR FUTURE FIREPLACE <br />ASSOCIATED BUILDING PERMIT # if applicable): <br />MECHANICAL <br />PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Fixture <br />" Count <br />List of Fixtures <br />Fixture <br />Count <br />List of Fixtures <br />Fixture <br />Count <br />List of Fixtures <br />Fixture <br />Count <br />List of Fixtures <br />r <br />A/C —Air Handling Units <br />9 <br />Gas Piping <br />Backflow Preventer (Inside Bldg) <br />Shower, Tub, or Combo <br />Boiler <br />Gas Range <br />Clothes Washer <br />Sink -Commercial (3-comp,prep, floor) <br />Clothes Dryer <br />Heat Pump&Ductless <br />Dishwasher <br />Sink -Residential (kitchen, bath. bar) <br />Duct System (Remodel) <br />Refrigeration <br />Drinking Fountain <br />Sink -Utility, laundry, mop <br />Exhaust Fans (Residential) <br />Commercial Ventilatior <br />(Not Heat/AC system) <br />Floor Drain <br />Toilet <br />Exhaust Hood (Type 1) <br />Hose Bibb <br />Urinal <br />Exhaust Hood (Type II) <br />Water Heater <br />Interceptor -Grease <br />Waste/Water Piping Repair <br />Exhaust Hood (Residential) <br />Wood Stove <br />Interceptor-Sand/Oil <br />Water Service (behind meter) <br />Forced Air Systems <br />Other: <br />Medical Gas <br />Water Valves or Fixtures <br />Gas Fireplace/InserVLog <br />Roof Drains <br />Water Heater <br />SPRINKLER i SUPPRESSION <br />SYSTEM <br />Sewage Ejector or Sump Pump <br />Other: <br />Water Sup7ression 7stem <br />No. o ea s <br />Chemical Suppression System <br />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 f 8.27 RCW and 296.200A WAC <br />City of Everett Official Use Only <br />PERMIT # .. r _ t <br />11/15/19 <br />{0wneriAuthorized Agent Signature Date (revised 1011012018) <br />