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PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN /SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 1(E)ever,. , Leveret wa ov;[ www.everettwa.govlpermits <br /> )(Blio- Bk ink OnlyL PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS:1717 COLBY AVE PROPERTY TAX#: <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: MICHELLE WHELAN TENANT BUSINESS NAME(Commercial): <br /> OWNER MAILING ADDRESS: STREET r 717 COLBY AVE <br /> city EVERETT STATE WA zip 98201 <br /> OWNER PHONE:425-309-3922 OWNER EMAIL: <br /> CONTRACTOR NAME:C M HEATING INC <br /> CONTRACTOR ADDRESS: STREET 1415 BROADWAY <br /> cn-r EVERETTSTATE WA zip 98201 <br /> CONTRACTOR PHONE:425-259-0550 CONTRACTOR EMAIL:DEBBIE@CMHEATING.COM <br /> CONTRACTOR LICENSE#(REQUIRED);CMHEAI*09554 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 01609• ;•r <br /> PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR 0 OTHER(Please Specify) <br /> cottrAcr NAME: CONTACT PHONE:425-259-0550 <br /> DEBBIE OONTACY EMAIL DEBBIE @CMHEATING.COM <br /> BUILDH..G INFORMATION <br /> Existing Use of Building: Contract Price of Work:$4435.00 <br /> Proposed Use of Building; 4I-$eat Source: ❑Gas OElectric ❑Other <br /> BUILDING USE: DSFR ETownhouse ODuplex ❑ADU ❑Multi-Family-#Units: ❑Commercial EAccessory Structure <br /> Type of Project: :New - DAddition ❑Remodel ❑RepairT.i. Sign ❑Sprinkler ❑Demolition, ❑Change of Use <br /> DESCRIPTION OF WORK: INSTALL FREESTANDING GAS STOVE-NO GAS PIPING <br /> ASSOCIATED BUILDING PERMIT# Ceb)f9 �•• <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Fixture Flxtur• Fixture Fixture <br /> Count List of Fixtures Count List of Fixtures Count List of Fixtures Count List of Fixtures <br /> NC—Air Handling Units Gas Piping Backflow Preventer(inside Bldg) Shower,'Tub.or Combo <br /> Boiler' Gas ReneClothes Washer Sink-Commercial(3-comp,prep,floor) <br /> Clothes Dryer Heat Pum.&Ductless Dishwasher _ Sink-Residential(kitchen,bath,bar) <br /> Duct System(Remodel) Refrieration Drinking Fountain Sink-Utility,laundry,mop <br /> Exhaust Fans(Residential) —Commercial Ventilatio Floor Drain Toilet <br /> Exhaust Hood pe f Not Heat/AC s stem) Hose Bibb Urinal <br /> Exhaust Hood(Type ll) Water Heater Interceptor-Grease Waste/Water Piping 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 /> t Gas Fireplace/Insert/Log Roof Drains Water Heater <br /> SPRINKLER f SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other: <br /> atarSuppresston.System. ( Ito.of-Heads .:" <br /> C:henttca(Suu Ptaate0n Sye ] 1 fin No.of 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.lam the owner,or/am authorized by the owner of this property to perform the work for which application is made, <br /> and/comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> py of Everett Official Use Only <br /> PER IT <br /> ,Q f 4 2/6/19 <br /> Owner/ thorized Agent Sig Lure Date (Revised f 0201 10 <br />