3715 UPLAND AVE 2019-09-24 - Laserfiche WebLink

PERMIT APPLICATIOi BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/ DEMOLITION 1011A117;"1- CITY OF EVERETT PERMIT SERVICES J 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 1 FAX 425-257-8857 1(E)everetteps@everettwa.gov E www.everettwa.gov/permits (Blue or Black;Ink Onl�YPlease));:::: : ::: ::::::PROJECT:SITE:INFORMATION._...:.: ....:..._. . . ...:.. .... _:. PROJECT SITE ADDRESS:2)-71' ( 1 ill 14 1,,., PROPERTY TAX#:f,t T L:j ^)f))"`f' fy)Ca `y")1 LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT.INFORMATION .. OWNER NAME: l\or @ieI Tf 1c brL s TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET 3---1 li 1s ()9 1 D, dr / Cry t✓ e�-ip•.-- �y STATE Y4 LP q 8 93 OWNER PHONE:4��-(()A. ,-(6c)1Q OWNER EMAIL: CONTRACTOR NAME: G&S HEATING CONTRACTOR ADDRESS: STREET 3409 EVERETT AVE CITY EVERETT STATE WA zrp 98201 CONTRACTOR PHONE: 425-252-4402 CONTRACTOR EMAIL: DAWN@gSHEATING.COM CONTRACTOR LiCENSE#(REQUIRED): GSHEAC*939RK CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 019685 PRIMARY CONTACT: 0 OWNER I (CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: DAWN WEiMER CONTACT PHONE: 425-252-4402 CONTACT EMAIL: DAWN@GSHEATING.COM • .:.: BUILDING PERMIT:APPLICATiON Existing Use of Building: RESIDENTIAL Contract Price of Work:$ t O0Oa Proposed Use of Building: RESIDENTIAL Heat Source: OGas ❑Electric El Other Building Type: FR-Detached ❑SFR-Attached 0 Duplex ❑Multi-Family#of Units: ❑Commercial [Industrial a, Type of Project: ew ❑Addition ❑Remodel ❑Repair ❑T,l. OSign ❑Sprinkler 0 Demolition ❑Change of Use DESCRIPTION WORK:'.I .ns"�!` .0t C,,t.i 01.4 4. c i-F(; or L`PI,ki 4-) p "T ke l�'f'i(-t ' E 3errictcliwep. ASSOCIATED BUILDING PERMIT#(if applicable): ::MECHANICAL;.PERMIT?APPLICATION:::: ; ..., PLUMBING':PERMIT:APPLICATION :_:. Type of Project 4New Addn Alteration _Repair Type of Project _New _Addn Alteration _Repair Fixtures List of Fixtures Fix#t rtes List of Fixtures F ixt� List of Fixtures Fixtures List of Fixtures A/C—Air Handling Units Heat Pump Toilet Backflow Preventer(inside Bldg) I Forced Air Systems Unit Heater Bathtub Urinal Gas Piping Boiler Lavatory(Wash Basin) Drinking Fountain Water Heater Refrigeration Shower Floor Drain Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap Gas Range Ducting Dishwasher Roof Drains Clothes Dryer Hookups Other. Clothes Washer Medical Gas Range Hood Water Heater Other. Exhaust Fan Sink(Service/Bar/Mop/etc.) Other SPRINKLER a/;SUPPRESSION°SYSTEM Chemical or Water I INo.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.tam the owner,or l am authorized by the owner of this property to perform the work for which application is made, and l comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only —A lI i0.1,, . ) f— i — eg PERM t(a� 1 -04?) OwnerlAuthprized Agent Signature Date (Revised 9/232016)