4734 BLACK FOREST LN 2019-06-19 - Laserfiche WebLink

IIM PERMIT APPLICATION BUILDING 1 MECHANICAL t PLUMBING t SIGN i SPRINKLER/DEMOLITION E 11 E R E T TCITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 WASHiNRTON (P)426-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits (Bins or Slack Ink Only Plow* PROJECT SITE INFORMATION • PROJECT SITE ADDRESS:4734 BLACK FOREST LN PROPERTY TAX#:29053100310200 LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION . OWNER NAME: DAVID WANG TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET4734 BLACK FOREST LN ctry EVERETT STATE WA ZIP 98203 OWNER PHONE:425.252.6373 OWNER EMAIL: CONTRACTOR NAME:SHANNON HEIGHTS HEATING, INC CONTRACTOR ADDRESS: STREET 18933 59TH AVE NE#107 cI- ARLINGTON STATE WA zip 98223 CONTRACTOR PHONE:360.435.7359 CONTRACTOR EMAIL:SHANNONHEIGHTSHEATING@GMAIL.COM CONTRACTOR LICENSE#(REQUIRED):SHANNHH842DJ CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 57962 PRIMARY CONTACT: ❑OWNER El CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:360.435.7359 GEORGE SCH MAUS CONTACT EMAIL:SHANNONHElGHTSHEATING@GMAIL.COM BUILDING INFORMATION Existing Use of Building:SFR Contract Price of Work:$3000.00 Proposed Use of Building:SFR Heat Source: OGas DElectric ClOther BUILDING USE: EISFR ❑Townhouse ❑Duplex EADU OMulti-Family-4 Units: ❑Commercial ❑Accessory Structure Type of Project: :New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign OSprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: REPLACE EXISTING FURNACE LIKE FOR LIKE ASSOCIATED BUILDING PERMIT#(if applicable): •MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION. Picturetura Fixture Fixture Count List of Fixtures count List of Fixtures Count List of Fixtures Count list of Fixtures A/C—Air Handling Units Gas Piping Backflow Preventer(Inside Bldg) Shower,Tub,or Combo Boner Gas Range Clothes Washer Sink-Commercial(3-camp,prep,floor) Clothes Dryer Heat Pump&Ductless Dishwasher Sink-Residential(kitchen,bath,bar) Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility,laundry,mop Exhaust Fans(Residential) Commercial Ventilatior Floor Drain Toilet Exhaust Hood(Type I) (Not Heat/AC system) Hose Bibb Urinal Exhaust Hood(Type ll) Water Heater Interceptor-Grease WasteNdater Piping Repair Exhaust Hood(Residential) Wood Stove Interceptor-Sand/Oil Water Service(behind meter) 1 Forced Air Systems Other: Medical Gas Water Valves or Fixtures Gas Fireplace/Insert/Log Roof Drains Water Heater SPRINKLER 1 SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other: Water Suppression System No.of heads Chemical Suppression System j No.of Heads 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 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 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, and!comply with the Stale Contractors Law 18.27 RCW and 296.200A WAC. / City of Everett Official Use Only �'-f'� PERMIT# //n�A[/p/ p//� Owner A or gent Ign ure ate (Revised 10/10/2018)