1008 LOMBARD AVE 2019-07-24 - Laserfiche WebLink

4877- PERMIT APPLICATION BUILDING/ MECHANICAL/PLUMBING /SIGN /SPRINKLER/ DEMOLITION 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.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: `y 0l\ , ,��i1,^�o tCy , _, PROPERTY TAX#: 7 pc 7)-1(7r)7Lft ("1 LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: 'Cr 6L'vr0v- S) --1 TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET (\(' t AVAJV2 J,,- d k'"V J CITY Y/(rip r STATE WA UP 9820* OWNER PHONE: l0 1— )(„4J,. -- 11-2., OWNER EMAIL: CONTRACTOR NAME:GS HEATING CONTRACTOR ADDRESS: STREET3409 EVERETT AVE ore, EVERETTSTATE WA zip 98201 CONTRACTOR PHONE:425-252-4402 CONTRACTOR EMAIL:I NSTALL@GSHEATING.COM CONTRACTOR LICENSE#(REQUIRED):GSHEAHC821 QR CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 60058 PRIMARY CONTACT: ❑OWNER ID CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:425-252-4402 DAWN WEIMER CONTACT EMAIL:DAWN@GSHEATING.COM BUILDING INFORMATION Existing Use of Building:RESIDENTAIL Contract Price of Work:$ gOO ) Proposed Use of Building:RESIDENTAIL Heat Source: pGas ❑Electric ❑Other BUILDING uSE: EISFR ETownhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure Type of Project: ❑New ❑Addition ❑✓Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition EChange of Use DESCRIPTION OF WORK: V__(.) 6LC.L1,00 nn ; A-S,. , 1. tA:y5 ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Fixture F7xture Fixture Fixture Count List of Fixtures Count List of Fixtures Count List of Fixtures Count List of Fixtures \ A/C—Air Handing Units Gas Piping Backflow Preventer(Inside Bldg) Shower,Tub,or Combo Boiler Gas Range Clothes Washer Sink-Commercial(3-comp,prep,floor) Clothes Dryer Heat Pump&Ductless Dishwasher Sink-Residential(kitchen,bath,bar) Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility,laundry,mop Exhaust Fans(Residential) Commercial Ventilator Floor Drain Toilet Exhaust Hood(Type I) (Not Heat/AC system) Hose Bibb Urinal Exhaust Hood(Type II) Water Heater Interceptor-Grease Waste/VVater Piping Repair Exhaust Hood(Residential) Wood Stove Interceptor-Sand/Oil Water Service(behind meter) k Forced Air Systems Other. Medical Gas Water Valves or Fixtures Gas Fireplace/Insert/Log Roof Drains Water Heater SPRINKLER I SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other: Water Suppression System No.of Heads Chemical Suppression System 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 f 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 51 °t ICl PVSAIT ofE7 .... 0., a ./.Owner/AutN'ct zedAgAgent.Signature Date 1 (Revised 10/ 0/2018)