4922 COLBY AVE 2019-01-29 - Laserfiche WebLink

PERMIT APPLICATION BUILDING/MECHANICAL I PLUMBING I SIGN /SPRINKLER 1 DEMOLITION M ._ CITY OF EVERETT PERMIT SERVICES 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 Ink;Only:Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: 41113a4. CA\,),,,,, A.4_, PROPERTY TAX#: P 0*-2- 3(6;.(1)20;0 LEGAL for new construction: Short Plat/subdivision .) Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: )(0.../1/4 \A),(fit- TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET G4 GCA tVy,1 A,L k.! " CrW 'TA Ay A;ti--- STATE (1.. Zip (1,47) OWNER PHONE: tk-ic- 0--- `g033 OWNER EMAIL: CONTRACTOR NAME: G&S HEATING CONTRACTOR ADDRESS: STREET 3409 EVERETT AVE cry 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 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:$ 1 t.c,r Qt)1'). Co Proposed Use of Building: RESIDENTIAL Heat Source: Gas ❑Electric ❑Other Building Type: [ SFR-Deta . _ ❑SFR-Attached ODuplex ❑Mu[ti-Family-#of Units: ❑Commercial ❑Industrial Type of Project: ❑Ne,.✓ ,0,,,I `n- ❑Remodel ❑Repair ❑T,I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WO`ipt �� F ( -O \)1? S f/' NA,L) Orale5 CLC' r 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) 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/..SUPPRESSION SYSTEM.. !Chemical or Water ' [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 onty 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!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 1627 RCW end 296.200A WAC. City of Everett Official Use Only ,L_______________________— PERMIT* l(011‘ 1110)0S-1)3L1 Owner/Authorized Agent Signature Date (Revised 9/23/2016)