|
PERMIT APPLICATION
<br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/ DEMOLITION
<br /> d , CITY OF EVERETT PERMIT SERVICES
<br /> 3200 CEDAR STREET,EVERETT,WA 98201
<br /> (P)425-257-8810 J FAX 425-257-8857 1(E);everpuepsoworottwa, lav I veivoteverettom.govitPermits
<br /> -
<br /> ,BI{1/;Or la �:� t �i*11vo'r lE"7tllT�IIMI OttIV1i k I ,:: ,LT:'---''' �r4 :.'. .,.. ir _� = "
<br /> PROJECT SITE ADDRESS:7417 JEFFERSON AVE TAX#: 00512300000100
<br /> LEGAL for new construction: Short Pt5t1subdvisiori Lot No. (attach copy of long legal description)
<br /> . :.04947rpicT',INFORM `YI.d ',47, . ..z 32 r
<br /> OWNER NAME: PHIL MANSFIELD TENANT BUSINESS NAME(Commercial):
<br /> OWNER MAILING ADDRESS: STREET7417 JEFFERSON AVE
<br /> ,
<br /> cn•y EVERETT STATE WA ZIP 98203
<br /> OWNER PHONE: 425-870-2283
<br /> OWNER EMAIL:NA
<br /> CONTRACTOR NAME:C.M. HEATING INC.
<br /> CONTRACTOR ADDRESS: STREET 1415 BROADWAY ,..,
<br /> civ EVERETT STATE WA zip 98201
<br /> ,CONTRACTOR PHONE:425-259-0550 CONTRACTOR EMAIL:KAILANA©CMHEATING.COM
<br /> CPKTRACTOR LICENSE 3 REOLSREt)tCRY OF EVERETT BUSINESS LICENSE QutE3EE3} 016098.
<br /> CM
<br /> PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR 0 OTHER(Please Specify)
<br /> CONTACT NAME: CONTACT PHONE:425-259-0550
<br /> KAILANA CONTACT EMAIL:KAILANACM3 EATING.COM Y''
<br /> {
<br /> - BUILDING;;INFORMATIGN "'
<br /> Existing Use of_BuildinQ: Contract Price of Work $9500
<br /> Proposed Use of Building Heat Source: OGas DElectricC1Other
<br /> BUILDING USE: DSFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family 7.#Units: ❑Commercial DAccessory Structure
<br /> Type of Project:_ONew.. DAddition ,DRemodel ❑Repair ❑T.I. ❑Sign DSprinkler ❑Demolition ❑Change of Use
<br /> O CRlf?TION or.1di RK LIKE IN KIND AIR HANDLER CHANGE OUT WITH HEAT PUMP INSTALLATION
<br /> A:SSO 1ATED BUILDING,PERMIT#(if iteptiopitt
<br /> MECHANICAL PERMIT APPL;I.CATION PI,UIMB NG PERMIy.AP1,PLU. 1 'IOM
<br /> Fixture List of Fixtures ibis', r List of Fixtures 1=Jxture List of Fixtures �'lxture List of Fixtures ,I
<br /> Count count Count ` Count .
<br /> A/C—Air Handling Units Gas Piping Backflow Preventer inside Bldg) Shower Tub or WCombo
<br /> - Boiler Gas Range ,Clothes Washer Sink-Commercial(a3-Com s;prep,floor) ,
<br /> Clothes Dryer i Heat Pump&Ductless T Dishwasher Sink-Residential(kitchen,bath,bar)
<br /> Duct System(Remodel) Refriferation Drinking,Fountain Sink-Utility,laundry,mop::
<br /> xhaust Fans(Residential Commercial Ventilatior Floor Drain " , Toilet
<br /> Exhaust Hood(Tpe I) (Not Heat/AO.s�ystem . Hose Bibb Urinal
<br /> Exhaust Hood(Type II) Water Heater Interceptor- Grease `Waste/Water Piping Repair
<br /> Exhaust Hood(Residential), Wood Stove Interceptor-Sand/Oil 4Water Service(behind meter),
<br /> t Forced Air Systems Other: Medical Gas Water Valves or Fixtures
<br /> Gas Fireplace/Insert/Log Roof Drains 'Water Heater
<br /> -
<br /> SPRINKLER:I sitipPitsitiOlkiiirstEM.,-,,,,fig, Sewage Ejector or Sump Pump Other:
<br /> WaterSuppression System `F3o.of Meads
<br /> ttemif I Suppression System No.of leads
<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;ort am authorized by the owner of this property to perform the work for which application is made,'i
<br /> and I comply with the State Contractors Law 18.27 RCW and 298.200A WAC, I
<br /> k
<br /> City of Everett Official Use-,.Onlli
<br /> . _
<br /> PERMIT#(1/ % 2-ur.\ ,6
<br /> ,<e/c.i.z.A/42.4 wrio,t)4, 1zJzsr1s
<br /> Owner/Authorized Agent Signature Date 04111 41/44°,042°143)°,042°f8)
<br />
|