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2511 58TH ST SW 2019-09-10
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2511 58TH ST SW 2019-09-10
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Last modified
9/10/2019 11:50:31 AM
Creation date
9/10/2019 11:50:30 AM
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Address Document
Street Name
58TH ST SW
Street Number
2511
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grr PERMIT APPLICATION <br /> BUILDING I MECHANICAL I PLUMBING I SIGN I SPRINKLER I DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> (Blue or Black Ink:Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: 'j d 1 -c—RS C1/4-. i.� PROPERTY TAX#: OncR R7,t) )2/1k--(03 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Q.,, ciicakt, TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 7 k.--k.\ �t-1,-- grS <br /> CITY - -.1/41�i., STATE ;,t,{A z1P '�2,03 <br /> OWNER PHONE: LANc.--j'( --t4011( OWNER EMAIL: <br /> CONTRACTOR NAME: G&S HEATING <br /> CONTRACTOR ADDRESS: STREET 3409 EVERETT AVE <br /> CITY EVERETT STATE _ WA zip 98201 <br /> CONTRACTOR PHONE: 425-252-4402 CONTRACTOR EMAIL: DAWN@gSHEATING.COM <br /> CONTRACTOR LICENSE#(REQUIRED): GSHEAC*939RK CITY OF EVERETT BUSINESS LICENSE*REQUIRED): 019685 <br /> PRIMARY CONTACT: 0 OWNER EECONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: DAWN WEIMER CONTACT PHONE: 425-252-4402 <br /> CONTACT EMAIL: DAWN@GSHEATING.COM <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: RESIDENTIAL Contract Price of Work:$ C0 Ob coV:;In 00 <br /> Proposed Use of Building: RESIDENTIAL Heat Source: yeas ❑Electric ❑Other . <br /> Building Type: r•SFR-Detached ❑SFR-Attached ❑Due!ex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial <br /> Type of Project ❑New ❑Addition ❑Remodel •Repayr' ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: <br /> .A;O,o ,Mc Lvj C <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL•.PERMIT APJEJJGTION PLUMBING PERMIT APPLICATION • <br /> Type of Project: _New_ Addn Alteratiotj. Repair Type of Project: _New _Addn _Alteration Repair <br /> #ofList o f Fixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> i A/C).-Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) <br /> 'R reed Air Systems Unit Heater Bathtub Urinal <br /> Gas Piping Boiler Lavato (Wash Basin) Drinking Fountain <br /> Water Heater Refrigeration Shower Floor Drain <br /> Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap <br /> Gas Range Ducting Dishwasher Roof Drains <br /> Clothes Dryer Hookups Other Clothes Washer Medical Gas <br /> Range Hood Water Heater Other: <br /> Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: <br /> SPRINKLER 1 SUPPRESSION SYSTEM <br /> !Chemical or Water I No.of Heads <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 <br /> 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 <br /> Building Official before being authorized under any circumstance.I am the owner,or 1 am authorized by the owner of this property to perform the work for which application is made, <br /> and/comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> PERM #( Q�f— 6 <br /> _v/rC.__ .. -- <br /> J-~ f�1S11 W)(0' )_r- <br /> Owner/Authorized Agent Signature Date (Revised 9/23/2016) <br />
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