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PERMIT APPLICATION <br /> eft-- <br /> BUILDING I MECHANICAL/ PLUMBING /SIGN/SPRINKLER I 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)everetteps@everettwa gov I www everettwa goWperrnits <br /> (fie;or Black Jnk Onyf i:,wiser _ PRi tiLoT 5 TE'.INFOItMI►Tt,QN ` ..,,s,:02.411,:„..,.,,„. : . 1 <br /> PROJECT SITE ADDRESS:6815 BEVERLY LANE, EVERETT, WA 98203 PROPERTY TAX#: <br /> LEGAL for new construction: Short Plat/subdivision Lot No, (attach copy of long legal description) <br /> CONTACt INFORMATION --,g!. <br /> OWNER NAME: CARL ANDERSON TENANT BUSINESS NAME(Commercial): <br /> ,a <br /> ......_........ .... <br /> OWNER MAILING ADDRESS: STREET6815 BEVERLY LANE <br /> cry EVERETT STATE .WA.. . zip 98203 <br /> OWNER PHONE: 206-491-4530 OWNER EMAIL:broncos1968cka@gmail.com <br /> CONTRACTOR NAME:C.M. HEATING INC <br /> CONTRACTOR ADDRESS: STREET 1415 BROADWAY <br /> cm EVERETT STATE WA ZIP 98201 <br /> CONTRACTOR PHONE:425-259-0550 CONTRACTOR EMAIL:DEBBIE@CMHEATING.COM <br /> CONTRACTOR_LICENSE#(REQU112ED):CMHEAI*09554 CITY OF EVERETT BUSINESS LICENSE REQUIRREDj: 016098 <br /> PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:425-259-0550 <br /> DEBBIE CONTACT EMAIL:DEBBIE@CMHEATING.COM <br /> BUILDING IINFORMA'ITIOk „ <br /> Existing Use of Building: Contract Price of Work:$1736 <br /> Proposed Use of Buildinga:. Heat Source;. ❑Gas ❑Electric ❑Otttel` .M „ ro <br /> BUILDING USE: OSFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure <br /> Type of Project: ❑New .❑Addition DRemodel ❑Repair DTI ❑S�Ign ❑Sprinkler 1:1Demolition 1EChange of Use <br /> DESCRIPTION OF WORK: REPLACE GAS WATER HEATER <br /> ASSOCIATED BUILDING PERMIT#(if applicable);,,, <br /> MECHANICAL,.PERMIT'APPLICATIION ,°` ',r'..70* PLUMB 0 PERMIT PPI I T.*Q1N1: <br /> Fixture Fixture Fixture Fixture ' — <br /> List of Fixtures List of Fixtures List of Fixtures List of Fixtures <br /> Count Count Count Count <br /> NC—Air Handling Units Gas Piping Backflow Preventer(Inside Bldg) Shower,Tub,or Combo --- <br /> Boiler Gas Ranfle Clothes Washer Sink-Commercial(3-comp,prep,floor) <br /> Clothes.Dryer Heat Pum&Ductless Dishwasher Sink-Residential(kitchen,bath,bar) <br /> Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility laundry,my <br /> Exhaust Fans Residential Commercial Ventilatio; Floor Drain Toilet <br /> Exhaust Hood(Type I) (Not Heat/AC system) Hose Bibb Urinal <br /> .H (Type Water Interceptor- e Waste/Wr.Piping Rep <br /> Exhaust Hoodood(Residentialli) Wood StoveHeater Interce•tor-SGreasandlOil Water Service behind,metairer) <br /> Forced Air Systems Other: <br /> y Water Valves or Fixtures <br /> Gas Fireplace/Insert/Log Roof Drains Water Heater <br /> SPRINKLER f._SUPPRESSIONRY$' 'iM <br /> Sewage _ P PumP Other: <br /> ater oppression stem o-of ea.s <br /> Chemical$uppressian System No.orHeads µ, <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.tam 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 16.27 RCW and 296.200A WAC. <br /> City of.Everett Official Use Only', <br /> _ PER/MIITT# Q' <br /> 12/17/18 ._ <br /> ---)p.bia,c.e, •aajleiry-Owner/ uthorized Agent 6gpature Date to"sed;wi uV20/8j` - <br />