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Sep.20.2016 3:18PM • • No.3800 P, 2 <br />P�RMIT APPLICA,��ON <br />BU�L�ING/MECHANICAL/PLUMBING/SIGN/SPRIN�CLER/DEMOLITION <br />CITY OF EVER�7T PERMIT SERVICE5 <br />320� Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.�veretiwa.org <br />ADDR�55; <br />� <br />TAX # <br />�L. for new construction: 5hort Plat/subdivision Lot No. (attach copy of long legal description) <br />ER ����� �(,� ��'� PhonelE-mail '"� W 'Z,�— `-'l�j% r�- , <br />drass <br />CANT: _ Owner _ Owner's Agent X Contracfor _ Contractor's Agent _ Tenant emuac proviae e ianer orconsernnom u,e �wnor co do�ro�k �n �n�;paee� <br />ONTRACTOR G&S HEATING <br />3409 EV�RETT AVE <br />BUILDING PERIIf1l7 APPLECATfON <br />Stste �ic. # GSHEACx930RK Ci eus. �ic. # 019685 <br />Prione/Email 425-252-4402 <br />CpNTACT FOR PERMIT <br />DAWN WEIMER 425-252-4402 DAWN@GSHEATI <br />Phone/E•mail <br />CONTRAC7 PRICE OF WORK �1�DQ•UO <br />Existing Use of Building _ � <br />Proposed Use of Building <br />Bui[ding type; � 5ing(e Family _ Duplex Townhouse _ Multi-Family _ Gommerciat <br />TV�e af project; New __ Addition Remodel Repair T,I. 5ign Sprinkler <br />DESCRIPTiON OF WORK (ddditional space provlded on the back): <br />�..�.{���1CR �il/� l�.z 1 \GC(.Q.� <br />0 <br />MECH�1NICpL PERM�i APPLICATION <br />Typa of ProJoct: �New�ddn �Alteretion _RApair <br />Show Number # of fixfures <br />A/C — air handlin units <br />Forced sir s stems <br />Gas i inq <br />Water heater <br />Gas fire lace <br />Gas ran e <br />Clothes d er <br />Ran e hood <br />F�chaust fan <br />Heat um <br />Unit heater <br />6oiler <br />Woodstove <br />Ductin <br />Other <br />SPRIh�wCLER / SUPPRESSION SYSTEM <br />Number of Heads <br />HEAT <br />olition Chanae of Use <br />PLUMBING PERMI7 ApPLICATION <br />Typo of Project: _New _/�ddn �Iteration _ROpair <br />Show Number (#) of fixtures <br />I Toilet <br />basin <br />KitChgn sink & disp <br />Dishwashar <br />GlOtheS washer <br />Water heater <br />5ink (service/bar/m <br />8ackflow preventer <br />Urinal <br />Drinking Fountain <br />FlOor drain <br />KooT arains <br />Medical Gas <br />Other <br />Other: <br />I hereby certify ihat I hav� road a11d exemltled �hls appllcation and knowthe sam0 to bc truc �rltl Co�red, Ap provlslo�s of Isws and ordlnancee goveming this type of work will be compl <br />withl whNher � ecMed herein or noi. The grantin9 of d pefmlt tfoes not presyme to glve authoriry to viofate or cancel ihe provision of any vt11Gr sbtt Of tOCal 13w tegulating co�structfon <br />Thet I am au on�cd by the oWner op th�s property to pertorm the work for which appliG3ti0r1 i4 rllade antl I comply wKh �he State Contractors Lew 18.27 RCW and 296.200A WAC. <br />�. I I � I l) �d <br />Ownar/Authorized Agent Sfgnature Date (Ravlsed 9/2014) <br />COI� <br />