Laserfiche WebLink
Jul. 28. 2016 7: 17AM No. 3411 P. 2 <br /> PERMIT APPLICATI&J <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 TAX if iT O _�J"®3 <br /> VAILIP �uCE9.. a1 - ��,u1s 51 It) r'ro �j <br /> LEGAL for new construction: Short Plat/ssu}bdivision Lot No. (attach copy oflong legal description) <br /> OWNER P(jtvif i 1�jt fj Y Phone/E-mail � 0'2Y— 3'— l61 1f <br /> Address Wily izediti _1 QA_At j City/State/Zip f,veLyj <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 /> • <br /> CONTRACTOR G&S HEATING State Lie.# GSHEAC*930RK City Bus. Lic.# 019685 <br /> Address 3409 EVERETT AVE Phone/Email 425252-4402 <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 30 D r Of) • <br /> Existing Use of 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 /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION t <br /> Type of Project: New_Atkin Alteration_Repair Type of Project: _New_Addrl __Alteration_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 /> Other Medical Gas <br /> SPRINKLER I 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 a orized by the owner of this property 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 /> Owner/Authorized Agent Signature Date (Revised 9/2014) <br />