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PERMIT APPLICATION <br /> BUILDING/MECHANICAL I PLUMBING/SIGN I SPRINKLER/DEMOLITION <br /> 4414" CITY OF EVERETT PERMIT SERVICES <br /> settitimd <br /> _� 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (p)425-257-8810 1 FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> (SIa Blackhilt O`� PROJECT S TE 1NFORMIMA�I <br /> ...� � Vit 1e�� u � . . :, .. . .... <br /> PROJECT SITE ADDRESS:5316 EAST DR PROPERTY TAX#: <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> AIS#{ <br /> .,... mss,�: .�. ��_.,. II� �!'TI41r1 -` '� 7 / prfia; 42:,»,��.. .. 4t..: <br /> OWNER NAME: WALT YOUNG TENANT BUSINESS NAME(Commercial): <br /> OWNER MAILING ADDRESS: sTREEr5316 EAST DR <br /> CITY EVERETT STATEWA zip 98203 <br /> OWNER PHONE:425-353-2779 OWNER EMAIL: <br /> . <br /> CONTRACTOR NAME:C.M. HEATING INC <br /> CONTRACTOR ADDRESS: STREEr1415 BROADWAY <br /> CITY EVERETT STATE WA zip 98201 <br /> CONTRACTOR PHONE:425-259-0550 CONTRACTOR EMAIL:DEBBIE@CMHEATING.COM <br /> CONTRACTOR LICENSE#(REQUIRED):CM HEAT*O95R4CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 10698: <br /> PRIMARY CONTACT: ❑OWNER I]CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:425-259-0550 <br /> DEBBIE CONTACT EMAIL:DEBBIE@CMHEATING.COM <br /> `,p' k f BUiLDiNG'INFORIK* 1 14 - : <br /> Existing Use of Building: Contract Price of Work:$1756.00 <br /> Proposed Use of Building: Heat Source: OGas DElectric DOther <br /> BUILDING USE: EISFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure <br /> Type of Project: :New ❑Addition ❑Remodel ['Repair CT.!. ❑Sign ❑Sprinkler ❑Demolition ['Change of Use <br /> DESCRIPTION OF WORK: <br /> REPLACE GAS WATER HEATER <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICALPERMIT APPLICATION r *PP ,. T ON <br /> .� .... ��PLUIUIBINGPLsRMIt' . , �t ATi <br /> Fixture <br /> Fixture Fixture Fixture <br /> List of Fixtures List of Fixtures List of Fixtures Ust of Fixtures <br /> Count count Count Count <br /> NC-Air Handling Units ,Gas Piping Backflow Preventer(Inside Bldg) y Shower,Tub,or Combo <br /> Boiier `Gas Range -Clothes Washer Sink-Commercial(3-comp,prep,floor) <br /> Clothes Dryer _Heat Pump&Ductless Dishwasher Sink-Residential(kitchen,bath,bar)` <br /> Duct System(Remodel) Refrigeration r -Drinking Fountain Sink-Utility,laundry,mop <br /> Exhaust Fans(Residential) Commercial Ventilatior, Floor Drain Toilet <br /> Exhaust Hood(Type I) .(Not H eat/AC system) Hose Bibb Urinal <br /> Exhaust Hood(Type II) 1 Water Heater Interceptor-Grease Waste/WaterPiping Repair <br /> Exhaust Hood(Residential) Wood Stove Interceptor-Sand/Oil Water Service(behind meter) <br /> Forced Air Systems Other: Medical Gas Water Valves or Fixtures <br /> Gas Fireplace/Insert/Log Roof Drains Water Heater <br /> SPRINKLER`/'SUPPRESSIO N SYSTEM ,:. Sewage Ejector or Sump Pump Other <br /> Water SUppressiots Systemtt <br /> o.oears <br /> Chernica suppression System JNo,of Heads 4'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 <br /> current federal,state,and local law.The granting of e permit only authorizes approved work and no deviations therefrom.Deviations must first be authorized in writing from the <br /> 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, <br /> and I comply with the Stale Contractors Law 18.27 RCW and 298.200A WAC. <br /> City of Everett Official Use Only , <br /> PERMIT <br /> f1211‘).... ativ." f 4 •1 # ( ' f -c <br /> Owne uthorized Agent S re: 5Date (ReVlsed•lotTo oi8) <br /> i <br /> ':' <br />