2109 VIRGINIA AVE 2019-04-17 - Laserfiche WebLink

PERMIT APPLICATION BUILDING/ MECHANICAL I PLUMBING/SIGN I SPRINKLER I DEMOLITION "1111 .—.‘ 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.govipermits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: 7 A (; \ - -j ry i ft PROPERTY TAX#: � O L{Li LEGAL for new construction: Short Plat/subdivision J Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: t (t), 9-)e Yr TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET V , I 1/4WA1Yt.t , Az- CITY STATE U ,¼ 21 zz OWNER PHONE: '-'C - Z grey- `7)/)' ; — 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 ©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 Proposed Use of Building: RESIDENTIAL Heat Source: pOas ❑Electric DOther Building Type: tSFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial Type of Project: ❑New ❑Addition El Remodel ❑Repair CIT.!. ❑Sign OSprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: [[m ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL.PERMIT APPLICATION PLUMBING PERMIT APPLICATION Type of Project: _New_ Addn ration Repair Type of Project: New Addn _Alteration Repair Fixtures List of Fixtures Fixtures List of Fixtures Fixtures List of Fixtures Fixtures List of Fixtures A/C-Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) t 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:t 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.t am the owner,or I am authorized by the owner of this property to perform the work for which application is made. and 1 comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT# P \V 7Y ED5-010 Owne`f/Authorized Agent Signature Date (Revised 9/23/2016)