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- • � <br /> PERMIT APPLICATlON <br /> BUILDINGIMECHANICAL/PLUMBINGISIGNISPRINKLERIDEMOLITI�N <br /> CITY OF EVERETT PERMIT SERV[CES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.evereitwa.org <br /> SITEADDRESS: r,G� PROPERTYTAX# P �r <br /> t� ` �` '� L"� �/ s <br /> LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long fegaf description) <br /> ` "� —1 <br /> OWNER (;�,E;''� PhonelE-mail <br /> Address � �~ CitylState2ip ���J} <br /> APPLICANT:�Owner _Owner's Agent X Contractor _,Contractor�S A9Bn1 �Ten2flt(must provide a letter oi consent from the ownarto do wodc in the space) <br /> CONTFtACTOR G&S HEATING State Lic.# GSHEAC*930RK City 8us. �ic.# 019685 <br /> Address 3409 EVERETT AVE PhonelEmail 425-252-4402 <br /> TENANT BUSENESS NAME CONTACT FOR PERMIT <br /> DAWN WEIMER 425-252-4402 QAWN@GSHEATIN .CON <br /> Phone/E-mail <br /> BUILDING PERMIT APPlICATION cONTRa,CT PRiCE oF WORK_ lZ,�i,��).,-��`� <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gas [actric other <br /> Building type: _Singfe Family _Duplex Townhouse _Multi-Family _Commercial <br /> T e of ro'ect: New Addition Remodel Re air T,I. Si n S rinkler Demolition Chan e of Use <br /> DESCRIPTION OF WORK(additiona!space provided on the back): <br /> � <br /> 1�U���'� ��� �u� `1v�S�u�.��J=-t��-. <br /> MECHANICAL PERMIT PLICATION PLUMB[NG PERMIT APPLICATION <br /> Type of Project _New`Addn Alteration epair Type of Project: _New_Addn _Alteration,Repair <br /> Show Number # of fiztures Show Num6er(# of fixtures <br /> A/C—air handlin units 7oilet <br /> Forced air s stems 8athtub <br /> Gas i in Lavato wash basin <br /> Water heater Shower <br /> Gas fire lace Kitchen sink&dis osal <br /> Gas ran e Dishwasher <br /> Clothes d er Clothes washer <br /> Ran e hood Water heater <br /> Exhaust fan Sink service/barlmo /etc. <br /> Heat um Backfiaw reventer <br /> Unit heater Urinal <br /> Boiler Drinkin Fountain <br /> Refri eration Floor drain <br /> Woodstove Grease tra <br /> Ductin Roof drains <br /> Other Medical Gas <br /> SPRINKLER/ SUPPRESSION SYSTEM Other: <br /> Number of Heads O#her: <br /> 1 hereby certify ihat I have read and examined;his applirztion and know the same to be trve and correct.All provisions of laws and ordinances goveming this type of work will be compl <br /> with wheth pecif herein or not,The granting of a permit does net presume to give authority to violate or cance'the provision of any other stete or local law regulating construction <br /> That!a utho' ed y the owne�of this propetty to perform the wo�k for which applicatlon is made and I comply with tne State Contractors Law 18,27 RCW and 296.200A WAC. <br /> � ��� <br /> O r/Author;ze enY Si re Date (Revised 9/2014) <br /> _ _ _.._.. __.,_ _. . I __. _. . _ _ _ . . . _ __ _ <br />