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Feb. 28, 2017 3 . 03PM No. 4950 P. 1 <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: PROPERTYTAX# PER <br /> I2;_ <br /> �i" 3 0 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal dascriptlon) <br /> OWNER Phone/E-mail <br /> Address Clty/State/Zip tj <br /> i <br /> APPLICANT: Owner _Owner's Agent X Contractor Contractor's Agent _Tenant(must provide a lt@er of consentfrom the ownerto do work in tha space) <br /> CONTRACTOR G&S HEATING state Lic.# GSHEAC*930RK City Bus. Lic.# 019685 <br /> Address 3409 EVERETT AVE Phone/Emali 425-252-4402 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> DAWN WEIMER 425-252-4402 DAWN @GSHEATIN .CCN <br /> Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gaslectr Other <br /> Building type: _Single Family _Duplex_Townhouse _Multi-Family _Commercial <br /> Type of project; New Addition Remodel Repair T.I. Sin Sprinkler Demolition Chane of Use <br /> DESCRIPTION OF WORK(acdditfonal space provided on the back): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Projact: —New--Addn )g�_4lteration_Repair Type of Project: _Naw_Addn Iteration_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 Dlshwasher <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 /> 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 antl examined this application end know the same to be true antl correct.All provisions of laws and Ordinances governing this type of work will be comp) <br /> with whether specifled herein or not.The granting of a permit does not presume to give authority to violatC or cancel the provision of any other state or local law regulating Construction <br /> That I am authoriz d by the owner of this property to perform the work for which application is made and I comply with the State Contra:tors Law 18,27 ROW and 298.200A WAC. <br /> Owner/Au o Agsnt Signature Date (Revised 9/Z074) <br />