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,' • • <br />� PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br />SITE ADDRESS: <br />.� <br />LEGAL for new construction: Short Plat/subdivis <br />OWNER <br />PLICANT: Owner <br />TAX # <br />Phone/E-mail <br />� d [J'—� ICity/State/Zip <br />No <br />PERN1IT # <br />i �,�'�l � � l/�/�� L L0� �'� " � <br />_(attach copy of long legal description) <br />�( ZJ � �s-j,.�`'��CG�- <br />r�-e-� � �i'�� "��57�6� <br />Owner's Agent %� Contractor _ Contractor'S AgBl1t _ TBIlaf1S (must provide a letter of consent from the owner to do work in the space) <br />CONTRACTOR G&S HEATING <br />Address 3409 EVERETT AVE <br />TENANT BUSINESS NAME <br />BUILDING PERMIT APPLICATION <br />State �ic. # GSHEAC*930RK City Bus. �ic. # 019685 <br />Pnone/Emai� 425-252-44C�2 <br />CONTACT FOR PERMIT <br />DAWN WEIMER 425-252-4402 DA,WN@GSHEATIN .CON <br />Phone/E-mail <br />CONTRACT PRICE OF WORK DD - OG� <br />Existing Use of Building HEAT SOURCE: <br />Proposed Use of Building Gas Electric Other <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family _ Commercial <br />Type of project: _ New Addition Remodel Repair T.I. Si n Sprinkler Demolition Chanqe of Use <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />��� �� <br />MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn "' Alteration _Repair <br />Show Number (#) of fixfures <br />A/C — air handling units <br />� � Forced air systems <br />( Gas piping <br />� Water heater <br />Gas fire lace <br />Gas ran e <br />Clothes dr er <br />Ran e hood <br />� Exhaustfan <br />� Heat pump <br />; Unit heater <br />Boiler <br />Refri eration <br />Woodstove <br />Ductin <br />� Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixfures <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (servicelbar/mop/e <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other: <br />Other: <br />I hereby certify that I have read and examined this application and know lhe same to be true and correct. All provisions of laws and ordinances goveming this type of work will be comp <br />with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provision of any other state or local law regulating construction <br />That I am uthorized by the owner of this property to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />� ��� I1� <br />Owner/Authorize gent Signature Date (Revised 9/2014) <br />