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PERMIT APPLICATION <br /> fir <br /> BUILDING/MECHANICAL/PLUMBING/SIGN /SPRINKLER/DEMOLITION <br /> T CITY OF EVERETT PERMIT SERVICES ft <br /> - 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 1(E)everetteingeverettwtgov I www.eyerettwa.goy/permits <br /> :: _PICOAI : �'L, PROJECT slitr0:tNPortMAVIvp <br /> PROJECT SITE.ADDRESS:608 65th PL SE PROPERTY TAX#:00713200000400 4 <br /> LEGAL for new construction: Short Platisubdivtslon tall No. (attach copy of long legal description) <br /> '14"T.,..-77 <br /> , - ... ars p iCO1tAC :. RMA VAI _re Z' r.. <br /> OWNER NAME: MICHELLE ARNESON <br /> TENANT BUSINESS NAME(Commercial): ,• <br /> OWNER MAILING ADDRESS: STREET 608 65TH PL SE ., <br /> clTy EVERETT.._ STATE_WA zip 98203 <br /> tOwNER PHONE 425-501-0892 OWNER EMAIL Mjarnesortt hotmall com <br /> CONTRACTOR NAME C.M. HEATING INC ;. <br /> CONTRACTORADDRESS: STREET 1415 BROADWAY <br /> atv EVERETT STATE WA zip 98201 t& <br /> 'pONTRACToR;PHONE:425-259-0550 ICONTRACTOR EMAIL:KAILANA@CMHEATING.COM <br /> CONTRACTOR LICENSE i'E(I OU(R ) CMHEAI 09554 CITY OF EVERETT BUSINESS LICENSE#(REQUI ED) 0 1609e j <br /> PRIMARY CONTACT: 0 OWNER CI CONTRACTOR ❑OTHER(Please Specify),. <br /> CONTACT NAME: CONTACT PHONE:425-259-0550 <br /> KARL-ANACONTACT EMAIL:KAILANA@CMHEATING.COM i <br /> -1 BU LDIING INFORMATIiON <br /> Existing,Use of,Building: Contract Price of Work:.S-10,200 I- <br /> Proposed Use of Building Heat Source: ❑Gas DElectric ❑Other <br /> ,Biit;Lt11HG USE: DSFR ❑Townhouse EiDuplex DADU ❑Multi-Family-#Units: UCommercial DAccesso -Structure --- <br /> Type of Project ❑New ©Addition 17.1Remodel ❑Repair DTI. 1:$1.9)1 ❑Sprinkler ❑Demolition ❑G.han, a-of Use <br /> iESCRIPTION OF WORK: LIKE IN KIND AIR HANDLER CHANGE OUT WITH HEAT PUMP ADD ON <br /> 'A▪SSOCIATED BUILDING PERMIT#(if applicabitil <br /> i <br /> i▪ ,.. :$ MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> FixtureFrxtun Fixture Fixture <br /> Count List of Fixtures count 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 1 Heat Pump&Ductless Dishwasher Sink-Residential(kitchen,, <br /> bath,bar) <br /> FSystem(Remodel) Refrigeration %Drinking Fountain Sink-Utility,laundry,mop' <br /> ,.,, <br /> i Exhaust Fans(Residential . Commercial Ventliatlor or Drain Toilet <br /> Exhaust Hood(Type I) (Not Heat/AC system) Hose Bibb Urinal <br /> Exhaust Hood]Type II) Water Heater Interceptor-Grease Weste/Water Piping Repair <br /> - Exhaust Hood(Residential)' Wood Stove Interceptor-Sand/Oil _ Water Service ' <br /> (behind meter) <br /> Forced Air Systems Other. Medical Gas Water Valves or Fixtures <br /> Gas Fireplace/Insert/Log Roof Drains Water Heater 4 <br /> ''SPRINNLRR 1 SUPPRESSION SIFSTEM, Sewage Ejector or Sump Pump Other <br /> tom.,, g 1 <br /> Water Suppression System 'o.ofFleads _ -. <br /> Chemical Suppression System No.ofTieads <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 1 <br /> current federal,stale,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/em 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 /> City of Everett Official Use Only. ' <br /> PER IT ....., r.4....„ <br /> 03/28/19 <br /> OWner/Autb'ofiiedAgent Signature Datta =(Revised t .a) ', <br /> : <br /> 1 <br />