1104 39TH ST 2019-08-08 - Laserfiche WebLink

PERMIT APPLICATION 'i BUILDING/ MECHANICAL I PLUMBING I SIGN/SPRINKLER/ DEMOLITION I' r CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps cr evereitwa.gov I www.everettwa.gov/permits (Blue or Black Ink Only Ploasa} PROJECT SITE INFORMATION PROJECT SITE ADDRESS:1104 39TH ST((3901 NASSAU ST) PROPERTY TAX#:00470700403000 LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) ._...: CONTACT INFORMATION OWNER NAME: DANIEL THOMPSON TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET 1104 39TH ST(3901 NASSAU ST) aTv EVERETT STATE WA zip 98201 OWNER PHONE: 360-649-5872 OWNER EMAIL:dht7nlne@yahoo corn CONTRACTOR NAME:C.M. HEATING INC pONTRACTOR ADDRESS: STREET 1415 BROADWAY aTv EVERETT STATE WA Zip 98201 CONTRACTOR PHONE:425-259-0550 CONTRACTOR EMAIL:DEBBIE@CMHEATI NG.COM CONTRACTOR LICENSE#(REQUIRED):CMHEAI"09554 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 016098 PRIMARY CONTACT: 0 OWNER ❑CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:425-259-0550 KAI LANA CONTACT EMAIL:KAILANA@CMHEATING.COM BUILDING INFORMATION Existing Use of Building; Contract Price of Work:$8500 Proposed Use of Building. ,Heat Source: ❑Gas DElectric ❑Other iBUILDING USE: EI ❑Townhouse ❑Duplex ❑ADU [_�Multt-Family-#Units; ❑Commercial F lAccesso Structure Type of Project: ❑New ❑Addition ❑Remodel ©Repair DTA. f.+Sign iSprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK; LIKE IN KIND AIR HANDLER CHANGE OUT WITH HEAT PUMP INSTALLATION ASSOCIATED BUILDING PERMIT#(if applicsbie): 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-camp,prep,floor) Clothes Dryer i Heat Pump&Ductless Dishwasher Sink-Residential(kitchen.bath.bar) Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility,laundry,mop , Exhaust Fans(Residential) Commercial Ventilation Floor Drain Toilet _ Exhaust Hood(Type I) (Not Heat/AC system) Hose Bibb Urinal Exhaust Hood(Type II) Water Heater Interceptor-Grease WasteMater 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 I 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 taw.Me granting of a permit only authorizes approved work and no deviations therefrom Deviations must first be authorized in writing from the x 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 16.27 RCW and 296.200A WAC. City of Everett Official Use Only 4 � /j f/,+� �j r� ,J/�� h/// PER IT • i / l.c Y v Y,��-.✓c Y 24 + }7.r'/t/c If 04/17/19 • d ✓ ®�� Owner/Authorized Agent Signature Date (Revised 10Jy. 0 8) ""