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• • <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.org <br /> SITE ADDRESS: �} PROPERTY TApX- # PERMIT# <br /> "I ��-� ��� �'�`� �� �0 � (��� , _ ;�., <br /> LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br /> OWNER l'� `; i!:,t,.�,.�w Phone/E-mail �l,�' S J � <br /> Address � t �•-�, • �� City/State/Zip � a_��,��c � '�i..-� I <br /> APPLICANT:_Owner _Owner's Agent X Contractor _Contractor�S A9efll _T@flaflt(must provide a letter of consent from the owner ro do work in the space) <br /> CONTRACTOR G&S HEATING State�ic.# GSHEAC*930RK City Bus. �ic.# 019685 <br /> Address 3409 EVERETT AVE Phone�Emai� 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 �I UD O � U <br /> Existing Use of Building HEAT S E: <br /> Proposed Use of Building Gas lectric Other <br /> Building type: ingle Fami _Duplex_Townhouse _Multi-Family _Commercial <br /> T e of ro ect. w Addition Remodel Re air T.I. Si n S rinkler Demolition Chan e of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> ��� ��k�.�..�'��`. ���� �, �� '�' � �`�� <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn _Alteration_Repair Type of Project: _New_Addn _Alteration_Repair <br /> Show Number(#)of fixtures Show Number(# of fixtures <br /> A/C—air handlin units Toilet <br /> Forced air s stems Bathtub <br /> Gas i in Lavator wash basin <br /> Water heater Shower <br /> Gas fire lace Kitchen sink&dis osal <br /> Gas ran e Dishwasher <br /> Clothes dr er Clothes washer <br /> Ran e hood Water heater <br /> Exhaust fan Sink service/bar/mo /etc. <br /> Heat um Backflow 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 Other: <br /> I hereby certify that I have read and examined this application and know the same to be true and correct.All provisions of laws and ordinances governing this type of work will be comp <br /> with whether specified herein or not.The granting of a permit does not presume to give authority to violate or cancel the provision of any other state or local law regulating construction <br /> That I am authorized by the owner of this propeRy to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> / .f� ._._ . �. � � � � � � � <br /> Ow rYAuthorized Agent Signature TDate (Revised 9/2014J <br />