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*010 [-II <br /> PERMIT APPLICATION <br /> BUILDING I MECHANICAL/PLUMBING /SIGN/SPRINKLER/ DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> 1 <P)425-257-8810 i FAX 425-257-8857 .1(E)everetteps@everettwa,gov t www,everettwa govipermits <br /> PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: 1PROPERTY TAX#: '"" <br /> 00437578401000 <br /> LEGAL for new construction: Short Plat/subdivision Lot No, (attach copy of long legal description) <br /> 3 , <br /> CONTACT INFORMATION <br /> OWNER NAME:BOB &WANDA BOLERJACK TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 3321 KROMER AVE <br /> CITY EVERETT STATE WA ZIP 98201 <br /> l ,, <br /> aOWNER PHONE:206 313 8667 OWNER EMAIL: <br /> CONTRACTOR NAME: MM COMFORT SYSTEMS <br /> CONTRACTOR ADDRESS: STREET 18103 NE 68TH ST SE, C-200 <br /> ciTv REDMOND STATE WA_ ZIP 98052 <br /> CONTRACTOR PHONE:425-881-7920 CONTRACTOR EMAIL:permits@mmcomfortsystems.COm <br /> CONTRACTOR LICENSE#(REQUIRED):MMCOMCS85564 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 055245 <br /> PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> I CONTACT NAME: CONTACT PHONE:425-881-7920 <br /> \iO� � \V l/‘ CONTACT EMAIL permits@mmcomfortsystems.corn <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: Contract Price of Work:$6346 <br /> Proposed Use of Buil !ng: Heat Source: ❑Gas ❑Electric ❑Other <br /> K. <br /> Building Type: SFR-Detached ❑SFR-Attached ❑Duplex` ❑Multi-Familyof Un(ks: ❑Commercial ❑Industrial <br /> i Type of Project: .New .❑Addition. ❑Remodel ❑Repair DTI. ❑Sign ❑Sprinkler ❑Demolition CI Change of Use <br /> t DESCRIPTION OF WORK;; INSTALL 1-HEAD DUCTLESS HEAT PUMP SYSTEM. <br /> 3, ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typo of Project: _New Addn „', Iteration _Repair Type of Project: _New _Addn _Alteration _Repair <br /> #of #of IT #of #of <br /> List of Fixtures List of Fixtures List of Fixtures List of Fixtures <br /> Fixtures Fixture Fixtures Fixtures <br /> Anits/C—Air Handling UI Heat Pump Toilet Backflow Preventer(Inside Bldg) <br /> Forced Air Systems '` ' - Bathtub Urinal <br /> Gas Piping Boiler ` Lavatory,{Wash Basin) Drinking Fountain <br /> Water Heater Refrigerationy Shower \`Floor Drain <br /> Gas Ftrepla Wood Stove Kitchen SS(nk$e DI osa(' Grease Trap <br /> •; Gas Range ...._ - .Ducting ._. Dishwasher Roof Drains <br /> Clothes Dryer Hookups -. ----Other: , 'Clothes Washer *Medical Gas <br /> Range Hood Water Heater Other: , <br /> Exhaust Fan_... Sink( f itiOMepietc,) Other: <br /> SPRINKLER I SUPPRESSION SYSTEM <br /> AMMO , ,_ <br /> 'Number cif Heads' <br /> 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 a 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 State Contractors Law 18,27 RCW and 296.200A WAC <br /> City of Everett Official Use Or* <br /> PERM <br /> �r/30 ie o-i- (0L <br /> , Owner!• horieed Agent Signature Date• (ffeV ,ten i 15,) <br />