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Ma r. 21. 2017 12 ; 28PM No. 5069 P. 1 <br /> ARMIT 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.everettwo_org <br /> SITE ADDRESS: PROPERTY TAX# P RM <br /> 0 S. ci i� Ov'�)l sspd�SUZ� �5 <br /> LEGAL for new construction. Short Plat/subdlvlslon Lot No, (attach copy of long legal description) <br /> OWNER (V,) Phone/E-mall <br /> Address -1 Y= Clty/State/Zip T �( <br /> APPLICANT._Owner _Owner's Agent X Contractor _Contractor's Agent _Tenant(rnuet provide a letter of consert from the owner to do wore;in the paCL) <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@GSHEATIN .CON <br /> Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORKjO�c,d <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Ogs Electric Other <br /> Building type: _Single Family _Duplex Townhouse _Multi-Fgmily ^Commercial <br /> Type ofproject: New Addition Remodel Repair T.I. Sin Sprinkler Demolition Chane of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _Now_flddnAlteration_Repair Type of Project: _New­Addn _Alteration_Repair <br /> Show Number(#)of fixiuras Show Number(# 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&dis osal <br /> Gas range Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood Water heater <br /> Exhaust fan Sink service/bar/mo /etc, <br /> Heat pump Backflow preventer <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> WQQdstDVe Grease trap <br /> Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER/ SUPPRESSION SYSTEM Other: <br /> Number of Heads Other: <br /> I hereby certify tnat 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 comps <br /> with whether spec tied herein or not.The granting of a permit does not presume to give authority w violate or cancel the provision of any other state or Iccal law regulating construction <br /> That I a razed 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 /> owner/Authorized Agent Signature fD to (Revised 912014) <br />