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PERMIT APPLICATION <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: D� PROPkie.c ��R�TIfTA Pt th6r67ii fir <br /> LEGAL for new construction: Short Plat/subdivision 1 NLot No. (attachtcopyofof long legalrdescription) Liejto2., <br /> OWNER st'ild 7/714Art*.. ..- Phone/E-mail (4 Lc--2r7 -c4( <br /> Address 9201 nazez City/State/Zip 'FA/AmI A %Tel <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 /> CONTRACTOR G&S HEATING State Lic.# GSHEAC*930RK City Bus. Lic.# 019685 <br /> Address 3409 EVERETT AVE Phone/Email 425-252-4402 <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 (a(TOO 00 <br /> Existing Use of Building HEAT SOURCE: <br /> V <br /> Proposed Use of Buildi V G Electric Other <br /> Building type: Single Fa y _Duplex Townhouse _Multi-Family _Commercial <br /> Type of project: Addition Remodel Repair T.I. Sign Sprinkler Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> Or V -' <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn •Iteratio _Repair Type of Project: _New_Addn _Alteration_Repair <br /> Show Number(#)o ' -s Show Number(#)of fixtures <br /> A/C—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 / 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 authorized by the owner of this property to perform the worklfor which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> Owner/A orized Agent Signature t cel�I ��ate (Revised 9/2014) <br />