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Feb, 15. 2017 12: 56PM Na, 4872 P, 2 <br /> �ERMtT APPL.ICATIO� <br /> BUILDII�G/M�CHANIC�IL/pLUIVIBIN�/SIGN/SPRINKLER/[)EMOLITION <br /> CITY OF EVERETT PERMIT S�RVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 vwvw.everettwa.org <br /> SITE ADDRESS: pRopE�rv rax# T <br /> � �3- - � 2-0 8' <br /> I.�GAL for new r,onStruCtiOn: ShoR Plabsubtlivision Lot No_ (attach copy of long lef�af description) <br /> OWNER J p�� [[,�� Phone/E-mail u1 � � �1 <br /> Address �' �� �.- • City/Stata/2ip `�}Qjtp� �{( <br /> APPLICAPlT__Owner _Owner'¢Agent X Gont�actor ,_,Contractor^s Agent _Tenant uat provlde a ietter r conaen�rrom 1he ownerto doxrork in the space) <br /> coNT�CTOR G&S HEATING State�ic.# G EAC'930RK City Bus, �ic.# 019685 <br /> Aadress 3409 EVERETT AVE Pt,o /Emdil 4 -252-4402 <br /> TENANT�USINESS NAME CONTACT FOR P RMIT <br /> , DAWN WEI ER -252-4402 DAWN@GSHEATIN .CON <br /> Phone/E-mail <br /> BUILDING PERMIT APPI.�CAT10N CON(TRACT PR10E O�WORK ��l)� <br /> Existing Usa o�Building HEAT SGURCE: <br /> Proposed Use of Building Gas Eiectric Otner <br /> Building type: _Sfngle Family _Duplex Townhouse _Multi-Family _Commercial <br /> T e of ro ect: New Addition Remodel Re air T.I. Si n S rinkler Derrtolition Chan e of Use <br /> DE5CR1p710N OF WORK(additiona!space provided on the back); . <br /> �`Gt.Ck �c�CR. <br /> MECI�IANyCAL p�RMIT APPLICATION PLUMBINC PERMIT pPPLICATION <br /> Type of Pr ' New_,_,Addn �pltaration_Rapair Typo of ProJ�cE: _New�4ddn _Alteratlon_Repair <br /> Sh w Number # offi�ur'es Show Number of fxfures <br /> A/C—air handlin units Toile! <br /> Forced air s stems 8athtub <br /> Gas i in Lavato wesh basin <br /> Water heatar Shower <br /> Gas fire lace Kltchen sink&dis osal <br /> Gas ran e Dishwasher <br /> Glothes d er Clothes Washef <br /> Ran e hood Water heater <br /> Exhaust fan Sink serviae/bar/iro /etc. <br /> Heat um Backflaw reventer <br /> Unit heater Urinal <br /> Boi(er Drinkin Fountain <br /> Refri eration Floor drain <br /> Woodstove Grease tra <br /> • Ductin Roof drains <br /> Other • Medical Gas <br /> SPRINKLER/SUPPR�SSION SYSTEM Other. <br /> Number of Heads Other: <br /> I hereby teRify that I nsve re,ad snd examined this epplication and know the seme to 6s trua end correct All provisi0na of IawS t�Ad ordinanCes gOVerning tnis ryGe of work will pe compl <br /> with whether specified hsrain or not,T[�C ghlnGn9 oF a perntR does�ot p�esume to gi�e suthoriry to vfolate or cancel the provision of any ather state ar Iocal law regulating constr�dion <br /> TI17R I am eutfto zed 6y the owner of thie praperty to perform the work forwhich applice6on is made Antl I Comply witfl tNe State CoMrBCtors Law is.27 iiC�N snd 2ea.2ooA WAC. <br /> y1 � 1 <br /> OwneNAut orized qgent signature Date (Revised 9/209�) <br />