5733 BROADWAY 2019-01-18 - Laserfiche WebLink

PERMIT APPLICATION BUILDING/ MECHANICAL/ PLUMBING/SIGN 1 SPRINKLER/DEMOLITION 0101 a _ CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits (Blue or Black Ink:Only Please): PROJECT.SITE INFORMATION:.... . . .. PROJECT SITE ADDRESS:5-7,;•21. Y k)(?l PROPERTY TAX#:,1, 0 SnS(Y)-- C)c q eiji LEGAL for new construction: Short Plat/subdivislon Lot No. (attach copy of long legal description) .... .: :::CONTACT INFORMATION OWNER NAME: 3P4(/t F.p 0,�p TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREETS-1 ?j3 •E(r(1�ri(k i * 5F., /�2 CITY EVr i lrf ''' STATE ( �A ZIP c)R CJ,'�J OWNER PHONE:1.-0,c-, �?(-{)a1.- OWNER EMAIL:se-1-11-f..?(Asor(o c m9,(1. (x` CONTRACTOR NAME: G&S HEATING CONTRACTOR ADDRESS: STREET 3409 EVERETT AVE CITY EVERETT STATE WA zip 98201 CONTRACTOR PHONE: 425-252-4402 CONTRACTOR EMAIL: DAWN@gSHEATING.COM CONTRACTOR LICENSE#(REQUIRED): GSHEAC*939RK CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 019685 PRIMARY CONTACT: ❑OWNER C(CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: DAWN WEIMER CONTACT PHONE: 425-252-4402 CONTACT EMAIL: DAWN@GSHEATING.COM .. :.:,.: ..:: ..:.......::::BUILDING:PERMIT.:APPLICATION......... .::..... Existing Use of Building: RESIDENTIAL Contract Price of Work:$ 4C,. 1( T t5byL, 10 Proposed Use of Building: RESIDENTIAL P 9 Heat Source: ❑Gas DElectric ©Other Building Type: IaSFR-Detached ❑SFR-Attached 0 Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial Type of Project: �lew ❑Addition ❑Remodel ❑Repair DTI. OSign ❑Sprinkler 0 Demolition ❑Change of Use DESCRIPTION ORK: 6�i E o +dco'- Onri- ASSOCIATED BUILDING PERMIT#(if applicable): .:.. MECHANICAL:PERMIT.APPLICATION : .PLUMBING.PERMIT:APPLICATION :.:::: Type of Project: _New ^, Addn _Alteration _Repair Type of Project: _New Addn Alteration _Repair Fixtures List of Factures Fixtures List of Fixtures Fixtures List of Fixtures Fixtures List of Fixtures 9 A/C—Air Handling Units 1 Heat Pump Toilet Backflow Preventer(Inside Bldg) Forced Air Systems Unit Heater Bathtub Urinal _ Gas Piping Boiler Lavatory(Wash Basin) Drinking Fountain Water Heater- Refrigeration Shower Floor Drain Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap Gas Range Ducting Dishwasher Roof Drains Clothes Dryer Hookups Other. Clothes Washer Medical Gas Range Hood Water Heater Other: Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: .:SPRINKLERJ::SUPPRESSION:SYSTEM..: Chemical or Water I No.of Heads ACKNOWLEDGEMENT:I have reviewed this application and confirm the information contained herein is true and correct Work done pursuant to this permit must comply with current federal.state,and local law.The granting of a permit only authorizes approved work and no deviations therefrom.Deviations must first be authorized In writing from the Building Official before being authorized under any circumstance.lam the owner,or!em authorized by the owner of this properly to perform the work for which application Is made, and!comply with the State Contractors Law 18.27 RCW and 296.200A WAC. IPA_ d City of Everett Oficial Use Onlyy 117.isiji4 PERMIT19) 11- 0°14 Owner/Authorized Agent Signature Date (Revised 9/23/2016)