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PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN /SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> N„filitiW4 ,. <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps©everettwa.gov I www.everettwa.gov/permits <br /> jiFORMATION;" <br /> ... " !iil' �;Ink Only" fir) PROJECT SITE I <br /> .. <br /> PROJECT SITE ADDRESS:6905 BEVERLY BLVD PROPERTY TAX#:28050700106000 <br /> LEGAL for new construction: Short Plat/subdivision _ Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: PATRICK/EMMA BAILEY TENANT BUSINESS NAME(Commercial): <br /> OWNER MAILING ADDRESS: STREET6905 BEVERLY BOULEVARD <br /> _aTr EVERETT STATE..WA ZIP 98203 , <br /> OWNER PHONE: 425-367-2490 OWNER_EMAiL:fulcrumxl5@gmaiicom <br /> CONTRACTOR..NAME:C.M. HEATING INC <br /> CONTRACTOR ADDRESS: STREET 1415 BROADWAY <br /> EVERETT <br /> aTr STATE WA zip 98201 <br /> CONTRACTOR PHONE:425-259-0550 CONTRACTOR EMAIL:KAILANA@CMHEATING.COM <br /> '-CONTRACTOR LICENSE#(REt 1RED):CMHEAI*09554 TOITY OF EVERETT BUSINESS LICENSE#REQUIRE[ 016098.. <br /> PRIMARY CONTACT: 0 OWNER ❑CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: ~CONTACT PHONE:425-259-0550 <br /> r <br /> KAI LANA CONTACT emit::KAIL S EAT(N :COr ,.. <br /> BUJLDINGINFORMATION" '. <br /> Existing Use of Building: Contract Price of Work:$6000 <br /> Proposed Use of Building: Heat Source: ❑Gas DElectric ❑Other <br /> , <br /> BUIUi)4G USE: IZSFR ❑Townhouse ❑D oi&x DADU ❑Multi-Fami -#Units: ❑Commercial DAccesso Structure <br /> ,,: f=of Pr#"eet: ❑New,. I2lAddition I Remodel DIRe•air _ <br /> T,I. I Sian Os./inkier ❑Demolition EDCha 0e,ofUse <br /> ESCRIPTION OF WORK: SINGLE ZONE DUCTLESS INSTALL <br /> ASSOCIATED BUILDING PERMIT#(if tlllobte:); 4 <br /> �..:.. _ MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Fixture List of Fixtures Flxfuro ListFixture Fixture <br /> Count coon~ of Fixtures Count List of Fixtures Count List of Fixtures <br /> AIC—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 D er i Heat Pum•&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 s stem ' Hose Bibb Urinal . <br /> '; Exhaust Hood(Type II) Water Heater Interce.tor-Grease aste/Water Pipin•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/Lo! `1 Roof Drains Water Heater <br /> `.SPRINiKILlelt I:SUPPRE$$ION SYSTEM Sewage Ejector or Sump Pump Other: <br /> wafer Suppression System - .`zF-To.of"Heads <br /> bbemlcai Suppression System l�to.of Reads - <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/comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> of Everett Official Use(frit v, <br /> / 4 , J'/� PERMIT# <br /> .L..tY !l/� i 03118/19 1 q D M <br /> Owner/Authorized Agent nature Date <br /> { 9 9 :(Bevis.., ;ti�+9'f3t21t1S) <br /> 9A <br /> 7, m <br />