10517 4TH DR SE 2019-05-23 - Laserfiche WebLink

PERMIT APPLICATION BUILDING/MECHANICAL/PLUMBING /SIGN I SPRINKLER I DEMOLITION CITY OF EVERETT PERMIT SERVICES s J 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 1 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: l PROPERTY TAX#: ,(y;'1(-(Z {C601)1t OLy LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: Cuk kAA jz, TENANT NAME(If Commercial): OWNER MAILING ADDRESS: s-rnezr t(,C -V''�'�_0 c.j^ CITY t �..JJ STATE � ZIP q ,0‹ OWNER PHONE: Lt-Li--1,1 ono � � OWNER EMAIL: 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: 0 OWNER aCONTRACTOR 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:$—� -�r71D. L) Proposed Use of Building: RESIDENTIAL Heat Source: ❑Gas jd'Electric ❑Other Building Type: CgSFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: " ❑Commercial ❑Industrial Type of Project ❑New ❑Addition .remodel ID Repair ❑T.1. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: Tje)'koktij V.U( 4 iv1S ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APP! TION PLUMBING PERMIT APPLICATION Type of Project: New Addn/r MeraY dJJ Repair Type of Project: _New _Addn _Alteration Repair Fixtures List of Fixtures 0 Fixtures List of FixturesFixtL eS List of Fixtures Fixtures List of Fixtures A/C—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 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.I am the owner,ori 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 end 296.200A WAC. City of Everett Official Use Only 1 I Ik P 1(.g- O3(4 OwnerCAt1thorized i ature- Date (Revised 9/23/2016)