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• • <br /> PERMIT APPLICATION <br /> BUILDING/ MECHANICAL/PLUMBING/SIGN/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 1(E)everetteps@everettwa.gov 1 www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: <br /> 24Q2 CLEVELAND AVE hPROPERTY TAX#:00516853201700 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) �. <br /> CONTACT INFORMATION <br /> OWNER NAME: GREG TAiT TENANT BUSINESS NAME(Commercial): <br /> OWNER MAILING ADDRESS: srREET2402 CLEVELAND AVE <br /> Cry EVERETT stare WA zp 98201 <br /> OWNER PHONE: 4252205934 ,OWNER EMAIL:GREG_TAIT@COMCAST.NET <br /> CONTRACTOR NAME:GS HEATING <br /> CONTRACTOR ADDRESS: srRear3409 EVERETT AVE <br /> CITY EVERETT STATE WA gp 98201 <br /> CONTRACTOR PHONE:425-252-4402 CONTRACTOR EMAIL:INSTALL@GSHEATING.COM <br /> CONTRACTOR LICENSE#(REQUIRED):GSHEAHC821 QR CiTY OF EVERETT BUSINESS LICENSE#(REQUIRED): 60058 <br /> PRIMARY CONTACT: El OWNER 1:3 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:425-252-4402 <br /> ALlSHA CLOGSTON CONTACT EMAIL:ALISHA@GSHEATING.COM <br /> BUILDING INFORMATION <br /> Existing Use of Building:RESIDENTAIL Contract Price of Work:$55°4.27 <br /> Proposed Use of Building:RESIDENTAIL Heat Source: Dias DElectric ❑Other <br /> BUILDING USE EJSFR ❑Townhouse ❑Duplex OADU ❑Multi-Family-#Units: _ DCommerciai ❑Accessory Structure <br /> Type of Protect: :New [addition ❑Remodel CI Repair DTI. ❑Sign ❑Sprinkler ODemolition ❑Change of Use <br /> DESCRIPTION OF WORK: GAS FURNACE REPLACEMENT <br /> ,ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Fixhrre _ Fixture Fixture Fixture <br /> Count List of Fixtures Count Count of Fixtures Count List of Fixtures Count List of Fixtures <br /> NC—Air Handling Units Gas Piping Backflow?reverter(Inside 8idg) , 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 Ventilation 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 /> _ i Forced Air Systems Other: Medical Gas Water Valves or Fires <br /> Gas Freptace/Insert/Log Roof Drains Water Heater <br /> SPRINKLER I 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 =--ewes 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 .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=. <°tired under any circumstance.i am the owner.or i am authorized by the owner of this properly to perform the work for which application is made, <br /> and I comply with the State . _=ctors Law 18.27 RCW and 298.200A WAC, <br /> City of Everett Official Use Only <br /> 04 1 <br /> PEFVen <br /> 0 - \ O <br /> Owner/Authorzed: ' nt ignature <br /> (Revised 10✓10I2018} <br />