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Nov. 15. 2016 2 : 00PM No. 4223 P. 1 <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 425257-8857 www.everettwa.org <br /> SITE ADDRESS: PROPERTY TAX# P # <br /> l l �\ Z-61 -C� U %►�c-1 cob b 1?CU �Q 1 I— t)924 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER n00 _ Phone/E-mail <br /> Address 1 OQ (i ,--Lerry, ! � cE City/State/Zip FAjrAi c 43 <br /> "Up <br /> APPLICANT:_Owner Owner's Agent X Contractor Contractor's Agent _Tenant(must provide a letter or consent from me owner to do work in the specs) <br /> CONTRACTOR G&S HEATING State Lie.# GSHEACx930RK City Bus. Lic.3lt 019685 <br /> Address 3409 EVERETT AVE Phone/Ercall 425-252-4402 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> DAWN WEIMER 425-252-4402 DAWN@GSHEATING.CON <br /> Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK gt.DUQ <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. Sign Sprinkler Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on fife book): <br /> k2e4) cat <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: Naw Mein JAiteratIon_Repair Type of Project: _New Addn _Alteration_Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> A/C—air handling units _ Toilet <br /> Forced air systems Bathtub <br /> Gas piping Lavatory(wash basin) <br /> Water heater _ Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood Water heater <br /> Exhaust fan Sink(service/bar/mop/etc.) <br /> Heat pump Backflow preventer <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> Number of Heads Other: <br /> I hereby certify thst I have read and examined this application and Know the same to be true and correct.All provisions of laws and ordinances governing 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 autho ¢ed by the owner of this property to perform the work for which application is made and l comply with the State Contractors Law 18.27 RCW and 290.200A WAC. <br /> VII 10 <br /> OwnerlAuthorized Agent Signature Date (Revised 9/2014) <br />