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PERMIT APPLICATION <br /> BUILDINGIMECHANICALIPLUMBINGISIGNISPRINKLERIDEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St, Everett,WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> SITE ADDRESS: PROPERTY TAX it, p <br /> l �4,% � S4- ra ) j°%, f .;�� �f 7O'/T lit fit, —011 <br /> if <br /> LEGAL for new construction�Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER �J'". io4 Ct- (L t ' �j <br /> j Phone/E-mail \`-Pt. <br /> ..-- 1 1 <br /> Address ')-A c --1i.- r\- S S- k City/State/Zip j v I L - 9t1A) 1 <br /> APPLICANT:—Owner _Owner's Agent X Contractor Contractors Agent Tenant(must provide a letter of consent from the owner to do work to The space) <br /> CONTRACTOR G&S HEATING State Lic.# GSHEAC*930RK City Bus. Lic.# 019685 <br /> Address 3409 EVERETT AVE Phone/Email 425-252-4402 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> DAWN WEIMER 425-252-4402 DAWN@GSHEATIN 4..CON <br /> Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK In!)0 <br /> Existing Use of Building HEAT SOURCE: <br /> 1 <br /> Proposed Use of Building �/ Gy ass) ElectricOther <br /> Building type: Single Family _Duplex Townhouse _Multi-Family —Commercial <br /> Type of project: New Addition Remodel Repair T.I._Sign_Sprinkler_Demolition.Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> 9:41,,aek, Cres,s RiVitk C52/. <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION • <br /> Type of Project _New Addn Alteration_Repalr Type of Project: _New_Addn Alteration_Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> NC--air handling units Toilet <br /> Forced air systems Bathtub <br /> ' Gas piping Lavatory(wash basin) <br /> Water heater Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood Water heater <br /> Exhaust fan Sink(service/bar/mop/etc.) <br /> Heat pump Backflow preventer <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> Ducting Roof drains <br /> Other _ Medical Gas <br /> SPRINKLER/SUPPRESSION SYSTEM Other: <br /> Number of Heads Other: <br /> I hereby certify that I have react and examined this application and know the same to be true and correct.All provisions of laws and ordinances governing this type of work will be comp) <br /> with whether specified herein or not.The granting of a permit does not presume to give authority to violate or cancel the provision of any other state or local law regulating construction <br /> That I am a h�zed 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. <br /> / 1, 1(1 <br /> OwnrfAuthorized Agent Signature 5 Date (Revised 9/2014) <br />