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Ap r, 1, 2016 3; 02AM No, 244b P. 3 <br />�RMIT APPLICATIO� <br />BUfLDING/M�CHA�NCALIPLUMBING/SIGN/SPRINKLER/DEMOLiTION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Evereit, WA 98201 �F�-257-8810 FAX 425-257-8857 www.evereitwa.org <br />SIT� ADbR�SS: PROPERTY TAX it PEA I# <br />� �_S� �� <br />LEGAL for new construction: Shorf I'IaVsuhdivision ___ Lol Nu. (at�ach copy of lony logal dcscrfptlan) <br />OWN�R ��S �Q�-�Ei� PhonclE-mali L'i�� J''.�l C��-- �%�' �� <br />Acidres:: �V ��i'�j '��d Y� � S� Giiy/Sfate/7iF� �3" Zi%�i <br />APPLICAN7; Ownor Owne��'sAflent X ConSractor Contractor'sAgent TenHntin,���:+r���������::,i�:u�:�„r�:����Y�„irr�rr�ineownarioaov,orkn,u,eapece� <br />CON7RAC70R G&S HEATING stat� ���. � GS�EAC*930RK c�c e��s. uc. � 019c,85 <br />�ddress 3409 EVERETT AVE �hone/Email 425-252-4402 <br />Y�NANT BUSINESS NAM� CONTACT FOR PERMIT <br />pAWN WEiMER 42�-252-aao2 �AWN�,a'�GSHEATIN .CO <br />Phonc/[ mail <br />BUILDING P�RiVIIT APPLICATION CONTRACT PRICE O� WOf�K � CJC� <br />Existirig U�e of B�filding _ ,__ f-iEAT SOIJttCE: <br />Proposed Use o[ f3uilding __, „, c;as Fl�c:t,ic: Uihor <br />BuiEding type. _ 5ii�glo Family ,_ Uupfex _'f�ownhouse _ Mulli-Family _ ComE�i�rcial <br />T e of ro-oct: New Addition Remodel Re all' T,I, 51 n 5 rinl<Ic�r Demolition Chan e of Use <br />DESCRIPT(ON OF WORK {add![lunal s�aco pmvidcd on the bacR) ; <br />MECHANiCAL PERMIT �1►PPLICATION PLUMBING PERMIT API'LICATIDN <br />7ypo of ProJect: "New �Addn _Alteraiion _Rapalr Type of ProJect: �„Ncw,,.,._,Addn ,_Alterat+on _Rgpair <br />Show Number (#) af �ixfures Show Number (tt) of fixtures <br />A/C — air handlinq units Toilnt <br />FOrCC�d �3ir s stems B�thtub <br />Gas i inq Lavator wash basin <br />Water heater Shower <br />Gas fire lace Kitchen sink & cfis osal <br />Gas ran e Dishwasher <br />CEothes dr er Clothes w�sher <br />Ran e hoad Water heater <br />Exhausf fan Sink service/bar/rno /elC. <br />H�at um Backflow reventer <br />U�Zit heater Urina4 <br />8oilqr Drinkinq Fauntain <br />Rofri or1tiqn �loor drain <br />Wooclstov� Gr�ase tra <br />�UCtin l�qqf drains <br />Uther MediCai Gas <br />S�RINKLER / SUPPR�SSION SYSTEM Ott�er: <br />Number of HeHds Ot}�er: <br />S I1FfP6y certify that I hava w�d and ex.u�llnPtl Illfs appl�catlon and know tho sema to bc lrcrc a�nd cotfr.r,(, I111 ptovlslons of tswa snd ordinancos flovomin41 this Sypr olVlolk V/lll l�e comp' <br />wi�h whclhci xper..11lerl herein or no�. I he gre nking of a permil does nn� �irF°ume to glve suthorlry to violata or c�ncd Ihc provision n( ��ty ntlier sssle or locel lew rogidating con�iruction <br />Tll�l I Am suthorized by ih ncr of tlds pfp pei iy �o perlorm the work for which applicatiun is rnarie 3n�i I comply wlth the Stete Contrectors La W 1II27 RGW 1il�f 296.7.00A WAO. <br />� ' <br />OwnerlAutharized Ag�rtt Slgn�turc Datc (R?vfsed 9/1p74f <br />