1404 HOLLOW DALE PL 2017-11-17 - Laserfiche WebLink

• S PERMIT APPLICATION BUILDING / MECHANICAL/ PLUMBING/SIGN / SPRINKLER/ DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: 1404 Hollow Dale PI #A PROPERTY TAX#: 00442800001201 LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: Gordon HIllStad TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET 1404 Hollow Dale PI #A CITY Everett STATE Wa ZIP 98204 OWNER PHONE: 4 2 5-68 1-4 8 93 OWNER EMAIL: CONTRACTOR NAME: Bobs Heating CONTRACTOR ADDRESS: STREET 14148 NE 190th S t CITY Woodinville STATE Wa Zip 980 CONTRACTOR PHONE: 800-840-3346 CONTRACTOR EMAIL: lhoneycutt@bobsheati CONTRACTOR LICENSE#{REQUIRED);BOBS HHA85 3NQ CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 54967 \ PRIMARY CONTACT: ❑OWNER I$CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: Lucinda Honeycutt CONTACT PHONE: 206-378-6735 CONTACT EMAIL: lhoneycutt @bobshe at ing. cora BUILDING PERMIT APPLICATION Existing Use of Building: SFR Contract Price of Work:$ 2500 . 00 Proposed Use of Building: Heat Source: OGas ❑Electric ❑Other Building Type: ❑SFR-Detached EtsFR-Attached ❑Duplex ❑Multi-Family-#of Units:_ OCommercial ❑Industrial Type of Project: ❑New ❑Addition laRemodel ORepair ❑T.I. ❑Sign ❑Sprinkler ODemolition ❑Change of Use DESCRIPTION OF WORK: like for like furnace replacement 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 List of Fixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures Fixtures Fixtures Fixtures Fixtures NC—Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) 1 Forced Air Systems Unit Heater Bathtub Urinal Gas Piping Boiler Lavatory(Wash Basin) Drinking Fountain Water Heater Refrigeration Shower 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 I-lood 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(rue 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 I am authorized by the owner of this property to perform the work for which application is made, and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only b 1.1."1 ^� PER/oQl t 1.1 � 3/17/17 � � � VO Owner/Authorized Agent Signature Date (Revised 5120/2016)