1616 EDGEMOOR LN 2019-01-28 - Laserfiche WebLink

PERMIT APPLICATION BUILDING /MECHANICAL!PLUMBING I SIGN/SPRINKLER/DEMOLITION ,"4 CITY OF EVERETT PERMIT SERVICES ` I 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwa.gov 1 www.everettwa.gov/permits (Blue or:Black Ilnk:`Oni Please Y: ):; ;.:::-:;::_: : PROJECT SIT£:INFORMQTION ::::::::::::;:: -: .. ....._......:. . .........,:......:;_.......:......:.:... PROJECT SITE ADDRESS: Vi I dr? p.( lip nom r- (..\ PROPERTY TAX*: ()0 7 i j IT-1 i✓ ;C ON)1(11 -- LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT:INFORMATION OWNER NAME: (3' v t 0. 1elc TENANT NAME(if Commercial): OWNER MAILING ADDRESS: UsTREET it,010 r -,n;n0 nAry—h{ Lr CITY \r iris:d-�4� - - STATE 1f{44 ZIP " ,:1?`1 2 OWNER PHONE: ,;)S-a:1A-S,g ,OWNER EMAIL: (‘-`,p nti ti„&Q(Z 6)Ci i"V1/?:d,Cncy% CONTRACTOR NAME: G&S HEATING ,....., CONTRACTOR ADDRESS: srREEr 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: 0 OWNER I`CONTRACTOR 0 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:$ 44 ii®--y Proposed Use of Building: RESIDENTIAL Heat Source: ❑Gas DElectric Daher Building Type: C(SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial [Industrial Type of Project: El New ❑Addition Cl Remodel El Repair ❑T.I. ElSign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: (?, s LI • r�,a n 014 V_ 6-14 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 #of List of Fixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures Fixtures Fixtures Fixtures Fixtures NC-Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) i 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. : SPRiNKLER`7:SUPPRESSION:SYSTEM ::.:::.:.: _ Chemical or Water I No.of Heads ACKNOWLEDGEMENT'I have reviewed this application and confirm the information contained herein is five end 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.I am the owner,or 1 am authorized 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. 0 r}L , City of Everett Official Use Only ,A t ti ` A/ P i{i - - I g PERMi ( Z(( o f 3 OwnerIAuthorized`Agerft Signature Date (Revised 9/23/2016)