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• • <br /> PERMIT APPLICATION <br /> BUILDINGIMECHANICAL,IPLUMBING/SIGN/SPRINKLER/DEMOL[TION <br /> CITY C)F EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 982�1 425-257-8810 FAX 425-257-8857 www.eueretiwa.org <br /> SITE DDRESS: ROPERTY A PE M17# � <br /> i;� ��s-����,�� � <br /> - <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (aftach copy of fong legal description} <br /> OWNER � �� �,t�,,Q� Phone/E-mai� �" � <br /> Address � a City/State2sp <br /> i <br /> APPLICANT:_Owner _Owner's Agent X C0lltfaClOf _COf1ff8C20f�S A92f1t _T0f18l12(must provide a letter of consent'rom ihe owner to tlo work in the space) <br /> CONTRACTOR G&S HEATING State �ic.# GSHEAC*930RK City Bus. Lic.# 019685 <br /> Address 3409 EVERETT AVE Phor.e/Email 425-252-4402 <br /> TENANT BUSINESS NAME CONTACT FQR PERMIT <br /> DAWN WEIMER 425-252-4402 DAWN@GSHEATIN .CON <br /> Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTF2ACT PRICE OF WORK S�D�-�'� <br /> Existing Use of Building ^x �1� c �_ EAT SOURCE: <br /> a <br /> Proposed Use of Building Gas Electric Qther <br /> Building type: _Single Family _bupiex_Tovunhouse _Multi-Family `Commercial <br /> T e of ro�ect; New Addition Remodel Re air 7.1. Si n S rinRler Demo(ition Chan e of Use <br /> DESCRfPT10N OF WORK(addi,ional space provided on the back): <br /> �t��, � ���A(�S <br /> MECHANICAL PERMIT APPLICATfON PLUMBING PERMIT APPLICAT[ON <br /> Type of Project: ,_„�New_Addn Alteratio _Reyair Type of Project: _New_Addn _Alteration_Repair <br /> Show Number(# of es Show Number # of fxtures <br /> A/C—air handlin units Toifet <br /> Forced air s stems � Bathtub <br /> Gas i in Lavato wash basin <br /> Water heater 1 Shower <br /> Gas fire lace I Kitchen sink&dis osai <br /> Gas ran e Dishwasher <br /> Clothes d er Clothes washer <br /> Ran e hood Water heater <br /> Exhaus*,fan Sink service/bar/mo /etc. <br /> Heat um Backflow reventer <br /> Uni:heater Urinal <br /> Boiler ' Drinkin Fountain <br /> Refri eration Floor drain <br /> Woodstove Grease tra <br /> Ductin Roof drains <br /> Othsr Medical Gas <br /> SPR[NKLER / SUPPRESSION SY'STEM Uther: <br /> Number of Heads Other: <br /> I here�y certify that I have reatl and examinetl this application and know the same to be true and correct.All provisions of laws and ordinances governing this type of work will ba comp' <br /> wi;h wheC�er specffied herein or not.The granting of a permR does not presume to give authonty to violate ar cancef the provision of any olher state or local law regulating constructicn <br /> That I am autfionzed by the owner of this prcperty to perform the work for which applicalion is made and I compiy with the State Contractors Law 1827 RCW and 296.200A WAC. <br /> ,� <br /> f�Ci' �fJ <br /> OwnerlAuthorized Agent Signature �at (Revised 9l2014) <br />