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May. 15. 2017 2 : 19PM N3. 5295 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: EPROPERTYTAX,# <br /> q�aq ET&-�4+ I -I—M� a <br /> LEGAL for new construction: Short Plevsubdivislon Lot No. (attach copy of long legal doscrlptlon) <br /> OWNER Phone/E-mall C <br /> Address l- – City/state/zip ( I <br /> APPLICANT:—Owner _Owner's Agent X Contractor _Contractor's Anent Tenant(must provido a lotlarof consonifrom the owner to do veork in the space) <br /> CONTRACTOR G&S HEATING State UG.# GSHEAC"930RK City BBs. Lir.# 019685 <br /> Address 3409 EVERETT AVE Phone/Small 425-252-4402 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> DAWN WEIMER 425-252-4402 DAWN@GSHEATIN COQ, <br /> Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 17:=5 <br /> Existing Use of Bullding HEAT SOURCE: <br /> Proposed Use of Building Gas X Electric Other <br /> Bullding type: Single Farnily _Duplex_Townhouse _Multi-Farnily _Cornlnercial <br /> Type of project: New Addition Remodel Re air T,1. Sin Sprinkler Demolition Chane of Use <br /> DESCRIPTION OF WORK(additional space provided on the back)' <br /> T►�s�a«c��1c�� cif- cwctle,�A I-10- pump <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typo of Project: _New,_Addn -LAIteratlon`Repa[r Type of Project: _New__4ddn _Alteration_Repair <br /> Show Number(#)of fixtures 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&disposal <br /> Gas range Dishwasher <br /> Clothes d erClothes washer <br /> Range hood Water heater <br /> Exhaust fan Sink service/bar/mo lefc. <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 Madical 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 pruvisiona of laws and ordinances governing this type of workwlll be comp) <br /> with whelhw spocified horain or not.The granling of a permil dots not presume to give authority to violate or cancel the provision of any other stale or[coal law regulating conslructlon <br /> That I am sulhorl7ed by the owner of this property to perform the work for which appllcatlon Is made and I comply wAh the State Contractors Law 19.27 RCW and 288.200A WAC, <br /> Anllil� kWlzz�z 5- 1"5- I]— <br /> wne uthorize Agent Signature Date (Revised 9/2014) <br />