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PERMIT APPLICATION <br /> girrBUILDING I MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 j FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> .(Blus'or.Black Ink Only Ploaa) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS:2431 HARRISON AVE PROPERTY TAX#: 00516853300100 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION..,.,. <br /> OWNER NAME: DANIEL MEINS TENANT BUSINESS NAME(Commercial): <br /> OWNER MAILING ADDRESS: sTeasr2431 HARRISON AVE <br /> omr EVERETT STATE WA ap 98201 <br /> OWNER PHONE: 4253156801 OWNER EMAIL:INSTALL@GSHEATING.COM <br /> CONTRACTOR NAME:GS HEATING <br /> CONTRACTOR ADDRESS: sTRaar 3409 EVERETT AVE <br /> ciry EVERETT SATE WA 21P 98201 <br /> CONTRACTOR PHONE:425-252-4402 'CONTRACTOR EMAIL:INSTALL@GSHEATING.COM <br /> CONTRACTOR LICENSE#(REQUIRED):GSHEAHC821 OR CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 60058 <br /> PRIMARY CONTACT: ❑OWNER ID CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:425-22524402 <br /> ALIS HA CLOGSTON CONTACT EMAIL:ALISHA@GSHEATING.COI <br /> % . BUILDING INFORMATION <br /> Existing Use of Building:RESIDENTAIL Contract Price of Work:$8000 <br /> Proposed Use of Building:RESIDENTAIL Heat Source: ❑Gas l7Electric ❑Other <br /> BUILDING USE: USER ❑Townhouse DDuplex ❑ADU ❑Mufti-Family-#Units: ❑Commercial ❑Accessory Structure <br /> Type of Project [New OAddition ©Remodel ❑Repair ❑T.I. OSign OSprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: <br /> DUCTLESS HEAT PUMP INSTALLATION <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION .,PLUMBING PERMIT APPLICATION , . <br /> F/xtursList of Fixtures Fixture List of Fixtures FlxtUre List of Fixtures Fixture List of Fixtures <br /> count countCount Count <br /> NC—Air Handling Units Gas Pipit Backflow Preventer(Inside Bldg) Shower,Tub,or Combo <br /> Boiler Gas Range Clothes Washer Sink-Commercial(3-comp,prep,fioor) <br /> Clothes Dryer i Heat Pump&Ductless Dishwasher Sink-Residential(kitchen,bath,bar) <br /> Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility,laundry,mop <br /> Exhaust Fans(Residential) Commercial Ventilatior Floor Drain ,Toilet <br /> Exhaust Hood(Type I) (Not Heat/AC system) Hose Bibb Urinal <br /> Exhaust Hood(Type II) Water Heater Interceptor-Grease Waste/Water Piping Repair <br /> Exhaust Hood(Residential) Wood Stove Interceptor-Sand/Oil Water Service(behind meter) <br /> Forced Air Systems Other. Medical Gas Water Valves or Fixtures <br /> Gas Firepiaee/Insert/Log Roof Drains —Water Heater <br /> SPRINKLER SUPPRESSION;:SYSTEM;:;:::.:;:, Sewage Ejector or Sump Pump Other: <br /> Water Suppression System -No.of Heads <br /> Chemical Suppression System 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 bei o authorized under any circumstance.I am the owner,ort am authorized by the owner of this property to perform the work for which application is made, <br /> and!comply with the Ste .ntractors Law 18,27 RCW end 298.200A WAC. <br /> g4 City of Everett Official Use Only <br /> 0 . <br /> �! PERM 6 1 - O 2-q <br /> DatOwner/Aatitio : n ignature (Revised 10/10/2018) <br />