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• • <br /> grr PERMIT APPLICATION <br /> BUILDING/ MECHANICAL I PLUMBING /SIGN /SPRINKLER/ DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES ; <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> (Blue or Black Ink Only Plows) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS:420 94TH ST SW PROPERTY TAX#:00726800000300 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> a <br /> CONTACT INFORMATION <br /> OWNER NAME: ALFONSO AGUIRRE TENANT BUSINESS NAME(Commercial), <br /> OWNER MAILING ADDRESS: STREET420 94TH ST SW <br /> CITY EVERETT STATE WA ZIP 98204 <br /> OWNER PHONE: 760-455-9211 OWNER EMAIL:aagu1rrec04@yahoo.COM <br /> CONTRACTOR NAME:C.M. HEATING INC <br /> CONTRACTOR ADDRESS: STREET 1415 BROADWAY <br /> cm, EVERETT STATE WA zip 98201 <br /> CONTRACTOR PHONE:425-259-0550 CONTRACTOR EMAIL:KAILANA@CMHEATING.COM <br /> CONTRACTOR LICENSE#(REQUIRED):CMHEAI"09554 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 016098;: <br /> PRIMARY CONTACT: 0 OWNER D CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:425-259-0550 <br /> KAI LANA CONTACT EMAIL:KAILANA@CMHEATING.COM <br /> BUILDING INFORMATION <br /> Existing Use of Building: Contract Price of Work:$15,000 <br /> Proposed Use of Building: Heat Source: ❑Gas CIElectric ❑Other _ <br /> BUILDING USE: DSFR ❑Townhouse DDuplex ❑ADU [ Mufti-Family-#Units: ❑Commercial LiAccessory Structure <br /> Type of Project: ❑New 'Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: MITSUBISHI HEAT PUMP INSTALL <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Fixture Fixture Fixture <br /> List of Fixtures Fixture <br /> Count count List of Fixtures Count List of Fixtures Count List of Fixtures <br /> NC—Air Handling Units Gas Piping _ Backflow Preventer(Inside Bldg) Shower,Tub,or Combo <br /> Boiler Gas Range Clothes Washer Sink-Commercial(3-comp,prep.floxx) <br /> Clothes Dryer i Heat Pump&Ductless Dishwasher Sink-Residential(kitchen,bath.ber) <br /> Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility,laundry,mop <br /> Exhaust Fans(Residential) Commercial Ventilatior Floor Drain Toilet <br /> Exhaust Hood(Type I) (Not Heat/AC system) Hose BibbUrinal <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 /> Forced Air Systems Other: Medical Gas Water Valves or Fixtures <br /> Gas Fireplace/Insert/Log Roof Drains Water Heater <br /> SPRINKLER I SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other <br /> Water Suppression System No,of Heads <br /> Chemical Suppression System I —No.of Heads <br /> 4 <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 1 am authorized by the owner of this property to perform the work for which application is made, '! <br /> 'and!comply with the State Contractors Law 18.27 RCW and 296,200A WAC. <br /> r'- City of Everett Official Use Only <br /> PERMIT/# �i <br /> ;u L4A 4/ 07/05/19 1 I, l r✓✓, 7 ~ / <br /> Ow (Revrsed t0/1t112(tf8) <br /> rter/Authorized Agent Signature Date / <br /> i <br />