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Sep, 14. 2016 8 : 48AM No, 3766 P. 2 <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 425-257-8857 www.everettwa.org <br /> SITE ADDRESS: � I At'z r PROPERTY Lt S tZ O 9 O 1 is O <br /> LEGAL for now construction: Short Plattsubdivision L�ott No. (attach copy of long legal jodescription) <br /> OWNER 1 Uab N*Pv,,�L1 Phcne/E-mail 25- (.006— X1659 <br /> Address l y 2A City/Stata/zip <br /> APPLICANT:_Owner _Owner's Agent X Contractor _Con tr$ctor'5 Agent _Tenant(must pravldo a IG xar of consent Ro n too awnct la�o wnrk In the sp:ccj <br /> CONTRACTOR G&S HEATING State Lic.# GSHEAC*930RK City Bus. Lic.# 019685 <br /> Address 3409 EVERETT AVE I Phone/Email 425-252-4402 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> DAWN WEIMER 425-252-4402 DAWN@GSHEATIN .COM <br /> Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building HEAT SOURCE: <br /> f <br /> Proposed Use of Building Gas Electric Other <br /> Building type; V Single Family _Duplex`Townhouse _Multi-Family J Commercial <br /> Type of ro[ect: New Addition Remodel Repair T.l_ Sin Sprinkler Demolition Chane of Use <br /> DESCRIPTION OF WORK(addiflonal space prov/ded on fhe back): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: New_ —Addn _Alteration_Repair Type of Project: _New_Addn _Alteration_Repair <br /> Show Number # of fixtures Show Number{# of fixtures <br /> A/C—a!rhandlin ,it, Toilet <br /> Forced airs stems Bathtub <br /> Gas pi ing Lavatory wash basin <br /> Water heater Shower <br /> Gas fireplace Kitchen sink&dls osal <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 tra <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 aPOCatiorl and know the same to be true and correct.All provisions or iaw9 and ordinances governing this type orwork will be compl <br /> with whether specifi herein not.Tf1C Qf ing of a permit does not presume to give euthoAly to violate or cancel the provl6lon of any other stele or local law regulating conatn,ctfon <br /> That I am aut]z y the ner Of 'operty to perform t11e work for which application Is made and I comply with the State Contractors Law 18.27 RCW and 296200A WAC_ <br /> Owner/qutlt ed A ant Sign Date (Revised 912094) <br />