5521 13TH AVE W 2019-07-09 - Laserfiche WebLink

PERMIT APPLICATION BUILDING/MECHANICAL/PLUMBING /SIGN /SPRINKLER/DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 [ FAX 425-257-8857 1(E)everetteps@everettwagov I www.everettwa.govipermits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: c 2 (3 ,L r. j PROPERTY TAX#: ()Mtnn(ZP;TV}Z..,r e LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: (..j \\ t AJ)U TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET S.c l *N` `k- L-) Cnv STATE ZIP OWNER PHONE: f r(l.t 0-�1 r1 r D 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: ❑OWNER E"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:$ Proposed Use of Building: RESIDENTIAL Heat Source: ,CGas ❑Electric ❑Other Building Type: ffSFR-Detached ❑SFR-Attached ODuplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. El Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: 2.41, kGteZ 9,0,3 1ttG2. ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Type of Project: _New _ Addii _eratrt o Repair Type of Project: _New Addn Alteration Repair #of - List of FixturesO List of Fixtures f #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 J f No.of Heads ACKNOWLEDGEMENT 1 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 1 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 (O P # l god-- 0Z� Re sed ed 9/23/2016 OwfeNAuthorized Agent Signature Date ( )