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Mar. 2, 2U17 7 : 24AM No. 49�9 F'. 2 <br /> �ERMIT APPLICATIO <br /> BUILDING/MECMANICAL/PLUMBING/SIG�V/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8890 FAX 425-257-8857 www.everetfwa.org <br /> SITE ADDRESS� PROPERTY TAX€� PE IT# <br /> (�tr� ��nd Q�ci� � � ' �� <br /> L�CyAL for new constructlon: Short PlaVsubdivision_ _LOt No. (attacn copy of long legal descrlption) <br /> OWNER V"l�L� � � Phone/E-mail 1��[,� ` �- � <br /> Addrass L�(�L� `I'� � CityiState/zip '`���y�,-r'� ��- C�.e^J� _ <br /> qPPLICANT:_Owner _Owner's Agent X Gontractor _Contractor's Agent _T0n8nt(m�st Pro��ae a�eeer o�coneen�rrom�,e ownar co ao wortc in u�e spawJ <br /> CON7K2ACTOR GB�S H�AT[NG State�ic.# GSHEAC"930RK City B�s. �ic.# 019685 <br /> .4ddress 3409 EVERETT AVE Phone/Emai( 425-252-4402 <br /> T�NANT BUSINESS NAME CONTACT FOR PERMIT <br /> DAWN WEIMER 425-252-4402 DAWN@GSHEAT[N .CON <br /> Phone/E-mail <br /> BUILD[NG PERIN�IT APPL1CpT10N CONTRACT PRICE OF WORK��`����� <br /> Existing Usa of Building HEAT SOURCE: <br /> Proposed Use af Building Gss Ele ric Other <br /> Building type: _Single Family _Duplex Townhvuse _Nfuiti-Famify �Commercial � <br /> T e of ro'ect: New Addition Remodel Re air T.[. Si n S rinkler Demollti�n Chan e of Use <br /> DESCf�Ip710N OF WORK(additlona!spsce provided on the back).; <br /> �p\Gt�- (,�-�Y �c�^G��' \����i-�-- �(,���'`�rJ"Q <br /> MECF[ANIGAL PERMIT APPLICATION PLUMBING PERM17 APt'LICATlON <br /> Typa o!ProJ�cf: _New�ddn Alteration I�epQir Typa of Projsct: _New�ddn �Alteration_Repair <br /> Show Number # vf fi u Show Number # of fxtures <br /> A/C—air handlin units Toilet <br /> Forced air s stems Bathtub <br /> Gas i in Lavato wash basin <br /> Water heater Shower <br /> Gas fire lace Kitchen sink&dis osa� <br /> Gas ran e Dishwasher <br /> Clothes d er Clott�es washer <br /> Ran e hood Water heater <br /> Exhaust fan 5ink service/bar/mo /etc. <br /> Heat um 6ackflow reventer <br /> Unit heater Urinal <br /> Boiler Drinkin Fountain <br /> RefriQeration Floor drain <br /> woodsto�e Grease tra <br /> Ductin Rpof drains <br /> Other Medical Gas <br /> SPRINMC�E�t / SUPPRESSlON SYSTEM Other: <br /> Number of Heads Other: <br /> I hereby cartity that I have read and exarYiinetl tllis Applicatlon an4 know t�e asme�0 6e�rue and correct.All proviaions of laws flnd ordinantCS qoveming this type M Work wfll be compi <br /> with whctfler=pGC�f1eC herein or not.The grentin8 of a permii dosa not prasume fa pivt authority to v�plate of cancel tne provision of sny rnher stste or locsl law regulating construcfion <br /> That I sm thorizsd by the awnar of tltiE property to peAorm tne wo(K for whlch spplication is made end I comply with ihc St�te Contrattors LaW 18,27 RCW enQ 29s,ZooA WAC. <br /> e� <br /> Own /Au nzed Agant Sfgnatur� Date <br /> (Revrsed 9/2014J <br />