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Feb, 1, 2�17 7 ; 46AM��"`'' "'"`� No, 47�8 P. 1 <br /> r�RMIT APPLICATIO�: <br /> BUILDING/MECHANICAL/PLUMBING/S1GN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT �ERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> SIT�ADDR15�; PROPER�YTAXti � r� IT��O � <br /> � b�U <br /> LEGAL for new constructlon� Short P1aVsccbdivision �ot No, (attaGh copy of Io�g legal desaription) <br /> OWNER n�l,Y\ Phone/E-mail 1 .r�Q —g3�-13 <br /> Address �v�, City/Stete/zip �Q.�., ' '��g-� <br /> APPLICANT:_Owner _Owner's Agant X Contractor _ContractoPS AgOnt _Tenant(m��cP�o�ia���vtc�rcrcon�c�ttrom u,o c�Nnvrto do Wor�in th�:�a=o) <br /> CONTRACTOR G&S HEATING State�ic.# GSHEAC�930RK Ci Bus_ �ic.# 019685 <br /> Address 3409 EVERETT AVE Phone/Emall 425-252-4402 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT �� <br /> � �-� <br /> PhoneDAnW N WEIMER 425-25��t#'402 DAW�@GSHEATIN .COf� <br /> BU��D�NGr P�RM1'�' A����C,ATION CONTRACY PR[CE OF WORK U�� � <br /> Exlsting Use of Building � HEA7 SOURC�v' <br /> a <br /> Proposed Use of Building Ga Elear -'�� oRher <br /> 6uilding type; _Singl� Family _Duplex_Townhouse _Multi-Family _Commerciaf � <br /> T e of ro'ecf: New Addition Remodel Re air T.I. Si n S rinkfer Demolition Chan e of UsE <br /> DESCRIPTION OF WORK(addifional space provided on the back): <br /> ���� �a� <br /> MECHANICAL PERMIT APPLICATION p�UIVI��I�G p��21VlIT APPLICATION <br /> jype of Project: _Naw_Atldq �Alteration_Repair Type of Project: _New_qddn _Afteration_Repair <br /> SNow Number of fixtures Show Num6er(# of frxtures <br /> A!C—air handlin unifs Toilet <br /> �orcad air s stems Bathtub <br /> Gas i in �avato wash basin <br /> Water heater $hower <br /> Gas fire lace Kitchen sink&dis osal <br /> Gas ran e �ishwasher <br /> Clothes d er Clothes washer <br /> Ran a hood Water heater <br /> Exhaust fan Sink service/bar/mo ietc. <br /> Heat um Backflow revenfer <br /> Unit heater Urinaf <br /> Boiler Drinkin Fountain <br /> Refri er�tion FlOor drain <br /> Woodstove GrBase tra <br /> Ductin Roof drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM other: <br /> Number of Heads Other� <br /> I hereby cer�lry lfts!I��ve reatl sntl exam3nea thls�ppll�stlon snd know the ssme to De true anC correcy.All provlgions ol I�s ana ortllnan�g gove�ning�his[ype of woi'ic will be c01+1p1 <br /> with whether spsc�ed harain or not.Tha pranting of e permit doas not prasumm to qivc authority to violeie or c�ncml ihe provision of any oiher steie or local lew regulating construction <br /> 7h�I sl'R�uth zed by ehe owner of thla property to perform the work for which epplicstian Is rqsde snd I camplywjth the Stste Cantrsctors Law 1 B.2Y RC W snd 298.2ooA WAC. <br /> _ I� '�� <br /> Owner/ thori gent Signature Date <br /> (Revised 9/2014) <br />