5214 BEVERLY LN 2019-07-12 - Laserfiche WebLink

4rErr PERMIT APPLICATION BUILDING 1 IVIECHANICAL / PLUMBING / SIGN t'IRINKLER/ DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS:5214 BEVERLY LANE PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: CRISTY LOVELESS TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET 5214 BEVERLY LANE CITY EVERETT STATE WA ZIP 98203 OWNER PHONE: 425-348-9371 OWNER EMAIL: CONTRACTOR NAME:C.M. HEATING INC CONTRACTOR ADDRESS: STREET 1415 BROADWAY cin, EVERETT STATE WA zip 98201 CONTRACTOR PHONE:425-259-0550 CONTRACTOR EMAIL:DEBBI E@CM H EATING.COM CONTRACTOR LICENSE#(REQUIRED):CMHEAI*09554 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 016098 PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:425-259-0550 DEBBIE CONTACT EMAIL:DEBBIE@CMHEATING.COM BUILDING INFORMATION Existing Use of Building: Contract Price of Work: $ 1806.00 Proposed Use of Building: Heat Source: 0Gas ❑Electric DOther BUILDING USE: OSFR ❑Townhouse ❑Duplex ❑ADU ❑Multi Family-#Units: _ ❑Commercial ❑Accessory Structure Type of Project: ❑New ❑Addition ❑Remodel ✓❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: REPLACE GAS WATER HEATER ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Fixture Fixture 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 Boiler Gas Range Clothes Washer Sink-Commercial(3-comp,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 Ventilatiok Floor Drain Toilet Exhaust Hood(Type I) (Not Heat/AC system) Hose Bibb Urinal Exhaust Hood(Type II) 1 Water Heater Interceptor-Grease Waste/Water Piping Repair Exhaust Hood(Residential) Wood Stove Interceptor-Sand/Oil Water Service(behind meter) Forced Air Systems Other: Medical Gas Water Valves or Fixtures Gas Fireplace/Insert/Log Roof Drains Water Heater SPRINKLER/SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other: Water Suppression System No.of Heads Chemical Suppression System .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.I am the owner,or I am authorized by the owner of this property to perform the work for which application is made, and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only )7`Owby PERMDebbie Bauers 30 Dale z01903,2133236-0700 3/12/19 D.)7- Owner/Authorized ner/Authorized Agent Signature Date (Revised 10/10/2018)