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Mar. 3. 20 17 8: 11AM No. 4965 P. 1 <br /> PERMIT APPLICATIOV <br /> BUILDINGIMECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVl=-RETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8310 FAX 425-257-8857 www.everettwa.org <br /> SITE ADDRESS: PROPERTY�# <br /> � � 10 O0 CD <br /> LEGAL for new constructlon: Short Plat/subdivision Lot No. (attach copy of long legal description) I <br /> OWNER S Phona/E-mall L1LY--2>-t <br /> Address 100- S City/State/Zip T--VWk– <br /> APPLICANT:—Owner _Owner's Agent X Contractor —Contractor's Agent _Tenant(must Frovlda a latter❑f consentfrom the owner to do work in the space) <br /> CONTRACTOR G&S HEATING State t_ic.# GSHEAC*930RK City Bus. tic.# 019685 <br /> Address 3409 EVERETT AVE Phona/Small 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 WORK' -00 <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of 13uilding Ggslectric Other <br /> Building type: _Single Family _Duplex_Townhouse ,_„_Multi-Family _Commercial <br /> Type of ro'ect: New Addition Remodel Repair T. Sin Sprinkler Demolition Chane of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typ®of Protect: _New__Addn Iteration_Repair Type of Project Now_Adan -Alteration_Repair <br /> Show Number # of fixtures Show Numbor # of f&tures <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 /> 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 and know the same to be true and correct.All provisions of laws End ordinances governing thio type of work vAl be cempl <br /> with whether spewed herein or not.The granting of a permit doer not presume to give authority to violate or cancel the provision of any other state or local law regulating 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 Lew 19.27 RCW end 296.200A WAC. <br /> 1,4 2J (r) <br /> Owner/ orize Agent Signature Date (Revised 9/2014) <br />