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• • <br /> PERMIT APPLICATION <br /> #4VIL-111P-All BUILDING /MECHANICAL/ PLUMBING/SIGN /SPRINKLER/ DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> ' y 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> (Slim or Black Ink Only Pismo.) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS:1908 BAKER AVE PROPERTY TAX#:00438438702900 <br /> LEGAL for new construction Short Plat/subdivision Lat No. (attach copy of long legal description) <br /> CONTACT.INFORMATION <br /> OWNER NAME: BREANNA HAGEN TENANT BUSINESS NAME(Commercial): <br /> OWNER MAILING ADDRESS: STREET 1908 BAKER AVE <br /> crrr EVERETT STATE WA ZIP 98201 <br /> OWNER PHONE: 425-879-9017 OWNER EMAIL:breanna.m.hagen@gmail.com <br /> CONTRACTOR NAME:C.M. HEATING INC <br /> CONTRACTOR ADDRESS: STREET 1415 BROADWAY , <br /> cnTv 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: ❑OWNER Cl CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:425-259-0550 <br /> `KAILANA CONTACT EMAIL:KAiLANA@CMHEATING.COM <br /> v <br /> BUILDING INFORMATION <br /> Existing Use of Building: Contract Price of Work:$8000 <br /> • <br /> Proposed Use of Building: Heat Source: CIGas 0Electric DOther <br /> BUILDING USE OSFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial DAccessory Structure <br /> Type of Project: ©New ©Addition ❑Remodel LJRepair DT,i. ❑Sitgn ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: 2 ZONE DUCTLESS INSTALLATION <br /> ASSOCIATED BUILDING PERMIT#(if applicable). <br /> I, MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Fixture Figure Fixture Fixture <br /> • <br /> Count List of Fixtures Count List of Fixtures Count List of Fixtures Count List of Fixtures <br /> _NC—Air Handling Units v Gas Piping Backflow Preventer(Inside Bldg) Shower,Tub,or Combo <br /> Boiler Gas Range _ Clothes Washer Sink-Commercial(3-comp,prep,floor) <br /> Clothes Dryer t Heat Pump&Ductless Dishwasher Sink-Residential(kitchen,bath,bar) <br /> Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility,laundry,mop <br /> Exhaust Fans(Residential) Commercial Ventilation Floor Drain Toilet <br /> Exhaust Hood(Type I) (Not Heat/AC system) Hose Bibb Urinal <br /> Exhaust Hood(Type II) Water Heater Interceptor-Grease Waste/Water Piping Repair <br /> Exhaust Hood(Residential) Wood Stove _ Interceptor-Sand/0il 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 l SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other: <br /> Water Suppression System INoNo.of of HeadsHeads <br /> Chemical Suppression System . <br /> ACI<NO WLEDGEMENT 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 /> Icurrent 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 /> ll9utlding 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 Only <br /> �j �y y/f 1 PERMIT T <br /> }'r Y(/,�,4 . 7Y �7'r ,0/t 09/19/19 ` I V i `� Cl L <br /> Owner/Authorized Agent Signature �\ ;! Date :(Revised 10/10/20W) <br /> i <br />