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• PERMIT APPLICATION • <br />BUILDING / MECHANICAL / PLUMBING / SIGN / SPRINKLER / DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />(P) 425-257-8810 1 FAX 425-257-8857 1 (E) everetteps@cverettwa.gov I www.everettwa.gov/permits <br />Blue or Black Ink On Pl sp PROJECT SITE INFORMATION <br />PROJECT SITE ADDRESS: 1715 GRAND AVE <br />PROPERTY TAX #: 00438034400600 <br />LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br />CONTACTINFORMATION <br />OWNER NAME: SEAN GOLDFINCH TENANT BUSINESS NAME (Commercial): <br />OWNER MAILING ADDRESS: STREET 1715 GRAND AVE <br />cnry EVERETT STATE WA ziP 98201 <br />OWNER PHONE: 425-327-2265 <br />OWNER EMAIL: Seang@goldflnchbros.COm <br />CONTRACTOR NAME: C.M. HEATING INC <br />CONTRACTOR ADDRESS: STREET 1415 BROADWAY <br />c,,y EVERETT STATE WA z,P 98201 <br />CONTRACTOR PHONE:425-259-0550 <br />CONTRACTOR EMAIL: KAILANA@CMHEATING.COM <br />CONTRACTOR LICENSE #(REQUIRED): CMHEAI*09554 <br />ICITY OF EVERETT BUSINESS LICENSE #(REQUIRED): 016098 <br />PRIMARY CONTACT: ❑ OWNER ❑� CONTRACTOR ❑ OTHER (Please Specify) <br />CONTACT NAME: <br />KAILANA <br />CONTACT PHONE:425-259-0550 <br />CONTACT EMAIL: KAILANA@CMHEATING.COM <br />BUILDING INFORMATION <br />Existing Use of Building: <br />Contract Price of Work: $ 12,000 <br />Proposed Use of Building; <br />Heat Source: ❑Gas ❑Electric []Other <br />BUILDING USE: OSFR ❑Townhouse LIDu lex ❑ADU ❑Muiti•Famil - # Units. ❑Commercial DAccessory Structure <br />Typo of Project ZNew ZAddition ❑Remodel ❑Re pair ❑T.I. JSi` rt ❑ a rinkler ❑tier' otition ❑char e of Use <br />DESCRIPTION OF WORK: 3 ZONE DUCTLESS HEAT PUMP INSTALLATION <br />ASSOCIATED BUILDING PERMIT # if applicable): <br />MECHANICAL <br />PERMIT <br />APPLICATION <br />PLUMBING PERMIT <br />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 />A/C — Air Handling Units <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 />i <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 11) <br />Water Heater <br />Interceptor -Grease <br />WasteMater 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 Fireplacellnsert/Log <br />Roof Drains <br />Water Heater <br />SPRINKLER <br />/ SUPPRESSION <br />SYSTEM <br />Sewage Ejector or Sump Pump <br />Other: <br />Water Suppression System <br />INo, of Heads <br />Chemical Suppression System <br />I <br />jNo. of Heads <br />>:ACKNt7VKEDGEMENr.' 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, slate, 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 Oniv <br />PERMIT# ^ ��0�— <br />OrOB/21l19 IY/ � 1t� <br />gent Signature Date (Remised 10110r2018) 4 <br />