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PERMIT APPLICATION <br />BUILDING ECHANICAL / PLUMBING / SIGN / RINKLER / DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />(P) 425-257-8810 � FAX 425-257-8857 �(E) everetteps(o�everettwa.gov � www.everettwa.qov/permits <br />PROJECT SITE INFORMATION <br />PROJECT SITE ADDRESS:4732 SEAHURST AVE PROPERTY TAX #: 00505700005307 <br />LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />CONTACT INFORMATION <br />OWNER NAME:,f EROME VOSS TENANT NAME (if Commerciai�: <br />OWNER MAILING ADDRESS: srREer4732 SEAHURST AVE <br />arv EVERETT srArE �/�/A zia 98203 <br />OWNER PHONE:425-750-3437 OWNER EMAIL: <br />CONTRACTOR NAME: MM COMFORT SYSTEMS <br />CON7RACTOR ADDRESS: srReeT 18103 NE 68TH ST SE, G200 <br />cirY REDMOND STATE WA ziP 98052 <br />CONTRACTOR PHONE:425-881-7920 CONTRACTOR EMAIL: JWELLS@MMCOMFORTSYSTEMS.COM <br />CONTRACTOR LICENSE #(REc1uIRED): MMCOMCS85564 CITY OF EVERETT BUSINESS LICENSE #(REQUIRED): OS4Z4O <br />PRIMARY CONTACT: ❑ OWNER ❑ CONTRACTOR ❑ OTHER (Please Specify) <br />CONTACT NAME: CONTACT PHONE:425-881-7920 <br />JANETTE WELLS CONTACTEMAIL:JWELLS@MMCOMFORTSYSTEMS.COM <br />BUILDING PERMIT QPPLIGATION <br />Existing Use of Building: Contract Price of Work: $ � � 2_ <br />Proposed Use of Building: Heat Source: ❑Gas ❑Electric ❑Other <br />Buildin T e: R-Detached ❑SFR-Attached ❑Du lex ❑Multi-Family-# of Units: ❑Commercial ❑Industrial <br />Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br />DESCRIPTION OF WORK: <br />GAS FURNACE REPLACEMENT WITH NEW, LIKE FOR LIKE <br />CHANGE OUT IN THE SAME LOCATION <br />ASSOCIATED BUILDING PERMIT #(if a plicable : <br />ACKNOWLEDGEMENT: 1 have review�d 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 pe�nit only authorizes approved work and no deviations theretrom. Deviations must first be authorized in wiiting from the <br />Buikfing Official before being authorized under any circumstance. I am fhe owner, or 1 am authorized by the owner of this property to perform the work for which application is made, <br />and 1 comply with the State Contractors Law 18.2�W and 296.200A WAC. <br />Signature <br />City of Eve�ett Officiai Use Only <br />PERMIT # �� � �� ' � � <br />�� � <br />(Revised 10/12/2015) 1� <br />��� � J � <br />�"J� / <br />