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0 10 <br /> PERMIT APPLICATION <br /> °1111Z, <br /> BUILDING I MECHANICAL/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 I(E)everetteps@everettwa.gov I www.everettwa.govtpermits <br /> (Blue or Black Ink Only Ineaso) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS:325 ELM ST PROPERTY TAX#:00606200003200 <br /> 'LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: GREG STAUDACHER TENANT BUSINESS NAME(Commercial): <br /> OWNER MAILING ADDRESS: STREET 325 ELM ST <br /> ci-v EVERETT SWAT WA zip 98203 <br /> OWNER PHONE: 425-343-3456 OWNER EMAIL:dIalpine331@gm ail.com <br /> CONTRACTOR NAME:C.M. HEATING INC <br /> ONTRACTOR ADDRESS: STREET 1415 BROADWAY <br /> cm EVERETT STATE WA zip 98201 '' <br /> t. <br /> CONTRACTOR PHONE:425-259-0550 CONTRACTOR EMAIL:KAILANA@CMHEATING.COM <br /> 1 <br /> CONTRACTOR LICENSE#(REQUIREDi.CMHEAI*09554 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 01609€; <br /> PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:425-259-0550 <br /> KAILANA CONTACT EMAIL:KAILANA@CMHEATING.COM <br /> BUILDING INFORMATION <br /> Existing Use of Building: Contract Price of Work:$12_000 w I <br /> Proposed Use of Building: Heat Source: ❑Gas DElectric ❑Other <br /> BUILDING USE. i]SFR ETownhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure <br /> Type of Project: ZNew [ Addition ©Remodel 1Repair ❑T.I. ❑Sign ❑,Sprinkler EDemolition DChange of Use <br /> DESCRIPTION OF WORK: <br /> (LIKE IN KIND AIR HANDLER CHANGE OUT AND HEAT PUMP INSTALLATION <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Fixture Fixture Fixture Fixture <br /> Count List of Fixtures Count List of Fixtures Count List of Fixtures Count List of Fixtures <br /> A/C—Air Handling Units Gas Piping Backflow Preventer(Inside Bldg) Shower,Tub,or Combo <br /> Boiler _ Gas Range Clothes Washer Sink-Commercial(3-camp,prep,floor) "�' <br /> Clothes Dryer t Heat Pump&Ductless Dishwasher Sink-Residential(kitchen,bath.barl <br /> Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility,laundry.mop ti <br /> Exhaust Fans(Residential) Commercial Ventilatior 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/Oil Water Service(behind meter) <br /> i Forced Air Systems Other: Medical Gas Water Valves or Fixtures <br /> Gas Fireplace/Insert/Log Roof Drains Water Heater <br /> SPRINKLER/SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other. <br /> Water Suppression System i No.df Heads <br /> Chemical Suppression System r 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 1 <br /> current federal,state, Iva/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 bete beingauthorized 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 1 comply with t Staterntractors Law 18.27 RCW and 296.200A WAC. i <br /> i <br /> City of Everett Official Use On'y t <br /> `. PER <br /> 1)1 <br /> �,,,,,, 10/07/19 V\I �� ` O J 1. <br /> /owner/Authorizod Aged" Tnatu Date (Revised 10/10/2018) <br /> i . <br /> r <br />