1303 W MUKILTEO BLVD 2019-07-08 - Laserfiche WebLink

PERMIT APPLICATION BUILDING 1 MECHANICAL/ PLUMBING 1 SIGN/SPRINKLER/ DEMOLITION /41?---. CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 FAX 425-257-8857 1(E)everetteps@everettwa.gov 1 www.everettwa.govlpermits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: 1.2r) t)'ic 14.Q.0 S-\V(3' PROPERTY TAX#:' 0�,�('�(�}M cll Jc\ LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: T--e rA (_()t i Iu , TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STT V.)3 puirjif-f 1:2) CITY •:ll l,f f.7}-t STATE ,o.VA ZIP ofes,ao OWNER PHONE:Xirj-c- —.2)1 cc ' 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 EXCONTRACTOR ❑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:$ Proposed Use of Building: RESIDENTIAL Heat Source: ❑Gas ❑Electric DOther Building Type: ISFR-Detached ❑SFR Attached ODuplex ❑Multi-Family-#of Units: ❑Commercial ❑industrial Type of Project: 4ew DAddition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: � �• (� N Jt -{ ynct ., ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION . PLUMBING PERMIT APPLICATION;;, Type of Project: O New Addn Alteration Repair Type of Project: New Addn _Alteration _Repair #of List of Fixtures #of List of Fixtures #of List of Fixtures #°f List of Fixtures Fixtures Fixtures Fixtures Fixtures A/C—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./: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,or I 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. City of Everett Official Use Only PERMIT#) QA 0,O 0�) - -1 PERMIT -a9 ,3 Owner/Authorized Agent Signature bate (Revised 9/23/2016)