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Dec. 15. 2016 8 : 19AM No. 4546 P. 2 <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLERJDEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St, Everett, WA 98201 425-257-8310 FAX 425-257-8857 www.everettwa.org <br /> 'SITE ApDRES�fC'r'' PL c� PROPIRI 1TAX��O��f�� Q `v " \ (.0( 2_63( <br /> LEGAL for new construction; Short Plat/subdivision Lot No (attach copy of long legal description) <br /> OWNER 9) Phone/E-mail tA`t...s--2)IA — 1� 1 <br /> Address `,\ cki0 City/State/Zip t:,m„ UIAA Llii:U3 <br /> ) <br /> APPLICANT:^Owner _Owner's Agent X Contractor _Contractor's Agent _Tenant(must provlae a letter orconsent from the owner to do vv..: the spa e) <br /> CONTRACTOR G&S HEATING State Lic.# GSHEAC*930RK City Bus. Lic.# 019685 <br /> Address 3409 EVERETT AVE Phone/Email 425-252-4402 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> DAWN WEIMER 425- - 4402 D WN@GSHEATIN .CON <br /> Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WO-K Z0flj .C• <br /> Existing Use of Building HEAT Sed RCE: <br /> • <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 the book): <br /> L`c l c R ' ' ' <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn X Alteration 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 that I have read and examined this application end 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 authoriz by the owner of this property to perform the work for which application is made and I comply with the State Contractors Lew 18.27 RCW end 206.200A WAC. <br /> /1'11ciR, <br /> Owner/Authorized Agent Signature Date (Revised 9/2014) <br />