10128 23RD DR SE 2017-10-25 - Laserfiche WebLink

• • �017 o 95, 5 PERMIT APPLICATION BUILDING / MECHANICAL / PLUMBING /SIGN / SPRINKLER/ DEMOLITION 4W77- CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 1 FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT SITE ADDRESS:10128 23RD DR SE,EVERETT wA 98208 PROPERTY TAX":28052000204400 LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME:CYNTHIA ABRAHAMSON TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET 10128 23RD DR SE ciTy EVERETT sTATE WA Zip 98208 OWNER PHONE:425-478-2632 OWNER EMAIL: CONTRACTOR NAME: MM COMFORT SYSTEMS CONTRACTOR ADDRESS: STREET 18103 NE 68TH ST SE, C-200 C,Ty REDMOND STATE WA ZIP 98052 CONTRACTOR PHONE:425-881-7920 CONTRACTOR EMAIL:PERM ITS@MMCOMFORTSYSTEMS.COM CONTRACTOR LICENSE#(REQUIRED):MMCOMCS85564 ICITY OF EVERETT BUSINESS LICENSE#(REQUIRED). OS524> PRIMARY CONTACT: ❑ OWNER 5�CONTRACTOR ❑ OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:425-881-7920 DAVID CLU ETT CONTACT EMAIL:PERMITS@MMCOMFORTSYSTEMS.COM BUILDING PERMIT APPLICATION Existing Use of Building: Contract Price of Work:$,0,000 Proposed Use of Building: Heat Source: ®Gas ❑Electric ❑Other Building Type: D�SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial Type of Project: ❑New addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: GAS FURNACE AND A/C INSTALL ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Type of Project: _New _ Addn Alteration _Repair Type of Project: _New _Addn _Alteration _Repair #of #of #of List of Fixtures List of Fixtures #of List of Fixtures List of Fixtures Fixtures Fixtures Fixtures Fixtures 1 A/C—Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) I Forced Air Systems Unit Heater Bathtub Urinal Gas Piping Boiler Lavatory(Wash Basin) Drinking Fountain Water Heater Refrigeration IShower Floor Drain Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap Gas Range Ducting Dishwasher Roof Drains Clothes Dryer Hookups Other: Clothes Washer Medical Gas Range Hood Water Heater Other: Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: SPRINKLER/SUPPRESSION SYSTEM Number of Heads 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 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 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, and 1 comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT 8-4-17 I Owner/Authorized Agent Signature Date (Revised 10/12/2015)