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Oct, 10, 2016 1:43PM � • No. 3R70 P. 2 <br />PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLERIDEMOLITION <br />CITY O� �VERETT P�RMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425�257-8810 FAX 425-257-8857 www.everettwa_org <br />S{TE <br />a <br />LEGAL for new oonstruction: Shon Platlsubdivision <br />ow�ER ��rDa .A�4,r �r� <br />Address �' J� �(�Vl.� �(Cj <br />APPLICANT: �, Owner _ Owner's Agent <br />coNrRa,cTOR G&S HEATING <br />Addreas 3409 EVER�TT AVE <br />PROPER7Y TAX #1 �jITI #_ <br />)U3�U�OiO� ��?l� � 1 ll/� �' <br />Lot No, (attacn Gopy of long lega] description) <br />Phone/E-mail <br />Contractor T Contractor's Agent <br />BUI�DING PERIV�IT APPI.iCAT[ON <br />State Lic. # <br />CONT. <br />� <br />� y�11..Q � � l.l .�i� —t o NJ � <br />_ Tenan� (musl provide s letter or conaant Trom tha o�Nnor to do w❑:k in J,e epsee) <br />GSHEAC�'930RK City 6us. Lic. # 019685 <br />P hone/Ernail 425-2 52-4402 <br />WN WEIMER 425-252-4402 DAWN@GSHEATIN .CON <br />na�l <br />�CT PRICE OF WORK � �!%I�D - QD <br />Existing Use af Building HEAT SOURGE: <br />Proposad Use of Building Gas <br />Buitding type: _ Single Family � Duplex _Townhouse _ Multi-Family � Commereial <br />Type of project: New Addition Remodel Repair T.I. Sign Sprinkler [ <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />�l��Q �a c�- <br />MECHANICA�. PERMIT APPL1CATlON <br />Type of Project: _Naw _Addn �Alteratio� _I�epair <br />ShowNum6ar # ofFxfures <br />A/C — air handling units <br />� Forced air svstems <br />Water heate <br />Gas fireplac <br />Gas range <br />Clothes drye <br />Range h�ad <br />Exhaustfan <br />B <br />stove <br />� Other <br />SPRINKI�ER / SUPPRESSION SYSTEM <br />Num6er of Heads <br />Otnar <br />hanae of Use <br />pLUMBING PERMIT APPL�CATI�N <br />TypeofProjact: _New_Addn _Alteration�Repair <br />Shaw Numbar (#) of flxtures <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Kitchen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink {service/bar/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 />f heroby cenlFy th� I have read and examined 1111s appl�catlon end know tha same to be tfue and correct. All provisions of laws antl ofdinances governing this type of work will be compl <br />with wnather specified herein or not, The granting of a pormR tloGs not presume to give authority to violatC or cancel the Rrovlsion of any other state or local law rCgulating co�struCUon <br />That I?m authonZed by tne owner of this property to perform the work for which applicatlon �s msue end E comply with the Staic Cvntfddors Law 18.2� RCN1 end 2A6.200A WAC. <br />wnsrlAuthorized Agent Signaturs Date (Revisetl 92o14) <br />