Laserfiche WebLink
Nov, 29. 2016 12.43PM No. 4360 P. 2 <br /> RERMITAPPL,ICATION <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 AD KESS: PROPERTY T <br /> MILL(( <br /> � d <br /> LEGAL for new construction: Short Plat/5u(b_division Lot No. (attach copy of long legal description) <br /> OWNE9--\ 0 17 <br /> Address City/State/Zip / <br /> APPLICANT:—owner _Owner's Agent X Contractor —Contractor's Agent _Tenant(must prov(de a fetter or consent rrom trio owner to do work in the spaco) <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 425-252-4402 DAWN @GSHEATIN3.CON <br /> Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gas K Electric Other <br /> Building type: _Single Family _Duplex_Townhouse _Multi-Family _Commercial <br /> Type ofproject: New Addition Remodel Repair T_l. Sin Sprinkler Demolition Chane of Use <br /> DESCRIPTI 0N OF WORK(additional space provided on the book): <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(N)of fixtures <br /> A/C;—air handling units Toilet <br /> Forced airs stems 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 /> Ran a 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 /> Refri eration Floor drain <br /> Woodstove Grease trap <br /> Dumno Roof drains <br /> Other Medical Gas <br /> SPRINKLER/SUPPRESSION SYSTEM other <br /> Number of Heads Other: <br /> I hereby certify that I neve read and examined this application and know the some to be true and correct.All provisions of Isws and ordinances governing this type of work will be compl <br /> wrtn 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 Isw regwIsting construction <br /> That I am authorized by the owner of this property to perform the work for which application Is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> ,// �I I2'!� 1�c." <br /> Owner/AuthorizeZAgent Signature Date (Revised 9/2014) <br />