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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: p , ,.- r l n PROPERTY T `# j p� )_ h O � <br /> Mv. 'V::-OUl—.l. %Y '"'�V�� e(,j' b \`t/ 13C.%Cl'•.ik.� _ P �T 1 V <br /> LEGAL for new construction: Short PlaVsubdivisiioon��� Lot No. (attach copy of long legal description) <br /> • <br /> OWNER ‘�/4 yti��2� %A-?R t. �=dC Phone/E-mail N ! k_— ChM )J �� <br /> 1 <br /> Address ` � {u`o}/-ti,I,% 1 " City/State/Zip tie v:x� fe c- <br /> APPLICANT:_Owner —Owner's Agent X Contractor _Contractor's Agent -Tenant(must provide a letter of consent from the owner to do work in the space) <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@GSHEATING.CON <br /> Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK cr `v:-':;;moi r," ) <br /> ExistingUse of g i� <br /> Building HEAT SOURCE: ' �... <br /> Proposed Use of Building Gas Electric Other <br /> Building type: Single Family _Duplex Townhouse _Multi-Family _Commercial <br /> Type of project: New Addition _Remodel _Repair T.I. Sign Sprinkler Demolition_Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> ? r' r r^ <br /> V ��v,r 40 <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn Alter in_Repair Type of Project: New_AddnAlteration_Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> NC—air handling units Toilet <br /> Forced air systems Bathtub <br /> Gas piping Lavatory(wash basin) <br /> Water heater Shower <br /> Gas fireplace Kitchen sink&disposal <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 Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> Ducting Roof drains <br /> • <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 l am authorieedj6y the owner of this property to perform the work for which application la made and 1 comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> n n <br /> Ownlr/Authorized Agent Signature Date (Revised 9/2014) <br />