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Jun, 20. 2017 1 : 09PM S No, 5472 P. 3 <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.arg <br /> SATE ADDRESS: PROPERTY TAX q PERMIT# <br /> LEGAL for new Construction; Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER phone/E-mail <br /> Address ✓ i City/State/21p � t <br /> v <br /> APPLICANT:—owner _Owner's Agent X Contractor _Contractor's Agent _Tanant(mast provide a letter of ctnsentfrom the owner to do work in the spat:) <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 WORK (n <br /> Existing Use of Building Q t i;P a HEAT SOURCE: <br /> Proposed Use of Buildingj�f"to /I+y_ Gas Electric Other <br /> Building type: X-Single Family _Duplex_Townhouse _Multi-Family _Commercial <br /> Type of ro'ect; New Addition Remodel _Repair T.1. Sin Sprinkler Demolition Chane of Use <br /> DESCRIPTION OF WORK(additional space provided on the back); <br /> s�0-015ji car-\esS hubf� fnp - a 4Qd►S <br /> MECHANICAL,PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New,4gddn _Aftaration_Repair Type of Project: _Naw_Adan 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&dis osal <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 [Drinkinp 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 cert ry that I have read end examined this application and know the same to he true and correct.All provisions of laws and ordinances governing this type cf work will be mmpi <br /> with whether specified nereln or not.The granting of a permit does not presume to give authority to vlolate or Canccl the provision of any other state or local law regulating construction <br /> That I em authorized by the owner of this property to perform the work for which application Is mode and I comply with the State Contractors Lew 18.27 RCM and 296.200A WAC. <br /> LA '(" �Aa�-�'n", — <br /> 'Ow a°r/Authorized Agent Slgnaturo D to (Revised 9/2094) <br />