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PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN 1 SPRINKLER I DEMOLITION <br /> I06CITY OF EVERETT PERMIT SERVICES <br /> '' 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> Oiii.or Black ink Only Mose) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS:2023 HOYT AVE PROPERTY TAX#: <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> ..•. :. CONTACT INFORMATION <br /> OWNER NAME: BOBBI MALONE TENANT BUSINESS NAME(Commercial): <br /> OWNER MAILING ADDRESS: STREET2023 HOYT AVE <br /> - <br /> cmr EVERETT STATE WA zip 98201 <br /> OWNER PHONE: 425-478-5632 OWNER EMAIL:BOBBIEMALONE440GMAiL.COM <br /> CONTRACTOR NAME:GS HEATING <br /> CONTRACTOR ADDRESS: STREET 3409 EVERETT AVE <br /> onY EVERETT STATE WA zip 98201 <br /> CONTRACTOR PHONE:425-610-4257 CONTRACTOR EMAIL:INSTALL( GSHEATING.COM <br /> CONTRACTOR LICENSE#(REQUIRED):GSHEAHC821 OR CITY OF EVERETT BUSINESS LiCENSE#(REQUIRE©): 60058 <br /> PRIMARY CONTACT: 0 OWNER EI CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:425-610-4257 <br /> MELANIE MENDENHALL CONTACT EMAIL:MELANIE@GSHEATING.COM <br /> BUILDING INFORMATION <br /> Existing Use of Building:RESIDENTAIL Contract Price of Work:$3074.03 <br /> Proposed Use of Building:RESIDENTAIL Heat Source: QGas DElectric DOther <br /> BUILDING USE; DSFR DTownhouse DDuplex DADU DMulti-Family-#Units: DCommercial DAccessory Structure <br /> Type of Project :New DAddition IZIRemodel DRepair OT.I. DSign OSprinkler DDemolition DChange of Use <br /> DESCRIPTION OF WORK: 80 TO 80 SWAPOUT AND AIR CLEANER INSTALLATION <br /> ASSOCIATED BUILDING PERMIT#(If applicable): <br /> MECHANICAL PERMIT APPLICATION :..;: :: : :... -.... PLUMBING PERMIT APPLICATION. <br /> FixtureForkore Fixture Fixture <br /> Count List of Fixturescourrt Listof Fixtures <br /> List of Fixtures Count List of Fixtures <br /> A/C—Air Handing 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 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 1 Other. FURNACE Medical Gas Water Valves or Fixtures <br /> Gas Fireplace/lnsert/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 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 cowry with <br /> currant federal,state,end 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 I am authorized by the owner of this properly to perforin the work for which application is made, <br /> end I comply with the State Contractors Law 18.27 RCW and 296.2004 WAC <br /> City of <br /> Everett Official <br /> ficial Use Only nly <br /> PERMIT# <br /> �/�li /a/ CCd /v1/ it , ,d110l b.-7 `. \ <br /> Owner/AuthojizeclAgent Signature Date (Revised 100/ 01) <br />