Laserfiche WebLink
PERMIT APPLICATION <br /> BUILDING/ MECHANICAL/ PLUMBING/SIGN /SPRINKLER/ DEMOLITIONCITY 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.gov/permits <br /> 18144°11: <br /> TT <br /> yI ,, „4�. 17 !ply P"I $I E. s fl..,,,Z ° �`. n t MATZO ,..,.��. 3�i��"`;�` �z;�" „��r,, <br /> .,. .,,��,,,,, ,,, ,, ,,,,4->.,�a .�,fsrl�s,ryhd h,,..,,.,,;,.... ,:_. Wil' <br /> PROJECT SITE ADDRESS:3702 ROCKEFELLER AVENUE PROPERTY TAX#:00438192203100 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER NAME: KAY HOLLEN BECK TENANT BUSINESS NAME(Commercial): <br /> OWNER MAILING ADDRESS: STREET 3702 ROCKEFELLER AVE <br /> CITY EVERETT STATE WA ZIP 98201 <br /> OWNER PHONE: 425-38-7248 OWNER EMAIL:NA <br /> CONTRACTOR NAME:C.M. HEATING INC <br /> CONTRACTOR ADDRESS: STREET 1415 BROADWAY <br /> CITY EVERETT STATE WA ZIP 98201 <br /> CONTRACTOR PHONE:425-259-0550 CONTRACTOR EMAIL:KAILANA@CMHEATING.COM <br /> CONTRACTOR LICENSE#(REQUIRED):CMHEAI*09554 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 016098 <br /> PRIMARY CONTACT: 0 OWNER CI CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:425-259-0550 <br /> KAI LANA CONTACT EMAIL:KAILANA@CMHEATING.COM <br /> toOlt � s � <br /> Existing Use of Building: Contract Price of Work:$5500 <br /> Proposed Use of Building: Heat Source: ❑✓Gas ❑Electric ❑Other <br /> BUILDING USE: IZISFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure <br /> Type of Project: ❑New DAddition ❑Remodel ©Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: LIKE IN KIND GAS FURNACE CHANGE OUT <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> ;< . ANI PERMICOPUCATI ..,` S H,r,... 4 ?,, <br /> FixtureFixture Fixture Fixture <br /> Count List of Fixtures coupe List of Fixtures Count List of Fixtures Count List of Fixtures <br /> A/C–Air Handling Units Gas Piping Backflow Preventer(Inside Bldg) _ Shower,Tub,or Combo <br /> Boiler 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 Drinking Fountain Sink-Utility,laundry,mop <br /> Exhaust Fans(Residential) Commercial Ventilatior Floor Drain _ Toilet <br /> Exhaust Hood(Type I) (Not Heat/AC system) 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 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 /> ,NN ,y <br /> •woo `Sewage Ejector or Sump Pump Other: <br /> Water Suppression System No.of Heads <br /> Chemical Suppression System 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 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 /> �j,, / � ) ,,f/� �. )l City of Everett Official Use Only <br /> /1.tYC L(V/L/.CQ i /fi'C, PER I (.$1.D` — O(05 <br /> 01/15/19 1 ` <br /> Owner/Authorized Agent Signature Date (Revised 10/10/2018) <br />