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Ap r, 19, 2017 10: 54AM No, 5179 P, 2 <br /> PERMIT APPLICATI� <br /> BL�ILnING/M�CHANICAL/PLUMBINGISIGN/SPRINKLER/QEIV�OI�ITION <br /> CITY OF EVERETT PERM17 S�RVICES <br /> � 32Q0 Cedar S#., �verett, WA 98201 425-257-88'[0 FAX 425-257�8857 www.everettwa.org <br /> 517�ADDRESS: PROP�RTY YAX# P R T# <br /> �t�' S-�� t,� f�8'DOpo�3s' _ <br /> LEGAL for new construction: Short P]atlsubdivision �ot No. (attach copy of long lega[descripfion) <br /> OWNER \ ,GL�� Phone/E-mail ��yt� �— <br /> aaa�ess � �-�l� c�ty,siete�z;p �t � <br /> APPLICAtJT:�Owner _Owner's Agent X Contractor _„Cont�actor�s Aqent �7en8r1�(muet proviEe a letter of coneentTrom tne owner tv tlowork In tha apace) <br /> CONTRACTOR G&S HEATING State Lic.# GSHEAC"930RK City Bus, �ic.# 019685 <br /> Address 3409 EVER�7T AVE Phone/Email 42�-252�4402 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> DAWN WEIMER 425-252-4402 DAWN@GSHEATIN .CON <br /> Phone/E-mal! <br /> BUII�DING PERM[Y APPLICATION co�TRACT PRICE OF WORK t-l�01��6� <br /> Existing Use of Building HFJaT 50URGE: <br /> Propvsed Use of Buifding Gas �ieotr' Ot�er <br /> Building type: _Singfe Family _Duplex TTownho�tse ,Multi-Family ,_,Gornmercial <br /> T e of ro'ect: New Addition Remode] Re air T,I. Si n S rinkler Demolition Chan, e of Use <br /> DESCRIPTION OF WORK(adaltlonal space provided on the back}: <br /> . 1�►s� �� ��° <br /> MECH,AW[CA,L PERM[T APPLICATION PI,UMB�NG PERMIT APPl.ICAT�OI� <br /> rypa ot Prajoct: _New_Addn terativ �,RepBir 7ypa of Pro)sct: _Nsw r,Addn �fteration_Repair <br /> 5how Numder(# of fixEures Show Number of fxfures <br /> A/C—air handiin units Toilet <br /> Forced air s stems Bathtub <br /> Gas i in Lavato wash basin <br /> Water heater Shawer <br /> Gas fire lace Kitchen sink&dis osal <br /> Gas ranqe Dishwasher <br /> Clathes d er Clothes washer <br /> Ran e hood water heate� <br /> � Exhaust fan Sink service/bar/mo ie#c. <br /> Heat um Backflow reventer <br /> Unit heater �rinal <br /> Bo�ler Orinkin Fountain <br /> Refri eration Floor drain <br /> Woodstave Grease tra <br /> DUCtin Roof draiRs <br /> Other Medical Gas <br /> SPRIf�KLER ! SUPPRESSION SYST�M Other: <br /> Number of Heads Other: <br /> I haraby cCrtiyillat I fltve read and examineC this appilcation end know the same to be trua end wffCct,A�prGvisions ollews and ordlnsnces goveming thie type of work wifl be compl <br /> with whether epecified herein or not.Tlte gr3nting of A Aermn Ooes not presume to gl�a authority to violsta or cencel ihe provision of sny oiher stat�o�foCal law rcgulating CAns�ructlon <br /> Tnat I am utho�lse0 py the owner of thie property to perform the work for which appiicaGon is made 21nd I complY wnR the State Cantrsctore Law 18.27 RCW end 296.200A WAC. <br /> � � �� <br /> Own A ed Agent 5ignature Date (Revised 9/20i4J <br />