712 COLBY AVE 2019-01-25 - Laserfiche WebLink

2 U111K10 477 PERMIT APPLICATION BUILDING / MECHANICAL/ PLUMBING /SIGN /SPRINKLER/ DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (F)425-257-8810 1 FAX 425-257-8857 1(E)everetteps©everettwa.gov I vnvw.everettwa.gov/permits . , P OJEGT SITE INFORMATION y PROJECT SITE ADDRESS:712 Colby Ave PROPERTY TAX#:00496813702700 LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME:Cynthla Hansen TENANT NAME(If Commercial): OWNER MAILING ADDRESS: sTREET712 Colby Ave CITY EVERETT STATE WA ZIP 98201 OWNER PHONE:206-941-3608 OWNER EMAIL:cynthia.hansen@seattlechildrens.org CONTRACTOR NAME: MM COMFORT SYSTEMS CONTRACTOR ADDRESS: STREET 18103 NE 68TH ST SE, C-200 CITY REDMOND STATE WA ZIP 98052 CONTRACTOR PHONE:425-881-7920 CONTRACTOR EMAIL:PERMITS@MMCOMFORTSYSTEMS.COM CONTRACTOR LICENSE#(REQUIRED):MMCOMCS85564 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 055245 PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: A 1 u /� CONTACT PHONE:425-881-7920 J E AH BARLOW V`/�' CONTACT EMAIL:PERMITS@MMCOMFORTSYSTEMS.COM BUILDING:PERMIT APPLICATION Existing Use of Building: Contract Price of Work:$3000 Proposed Use of Building: Heat Source: ❑Gas ❑Electric ❑Other Building Type: ❑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: INSTALL GAS FURNACE 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 A/C—Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) 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 Hood Water Heater Other: Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: 1 GAS FURNACE ,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 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 1 14 ZA PERT#f,..—N —10c4 Owner/Au hor zed Agent Signature Date (Revised 101/12/2015)