1811 DULL PL 2019-08-07 - Laserfiche WebLink

41EFT PERMIT APPLICATIOIV BUILDING 1 MECHANICAL 1 PLUMBING /SIGN/SPRINKLER 1 DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 ](E)everetteps@everettwa.gov 1 www.everettwa.gov/permits (9u.orBlack?lnk:OnIyPluas�}. ............:.PROJECT.SITE INFORMATION ;::: :::::; .:::;..:.:::::::: ..>:::.:.:.... ...:::..::.:.;. :::;.;::::: . :::.. ....: .::..,: PROJECT SITE ADDRESS: % \ .c.)k.W\ c, PROPERTY TAX#: ?...14°(-VIOCM c:2d,� LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) OWNER NAME: V ` c,..._,..)9\--- TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET \ \ cJ\\ cli,,,, cnv -F,, , p A,y*R STATE WA ZIP 98203 OWNER PHONE: (1` S-- i -- ,4cVJ OWNER EMAIL: CONTRACTOR NAME:GS HEATING CONTRACTOR ADDRESS: sTREET3409 EVERETT AVE CITr EVERETT STATE WA zip 98201 CONTRACTOR PHONE:425-252-4402 CONTRACTOR EMAIL:INSTALL@GSHEATING.COM CONTRACTOR LICENSE#(REQUIRED):GSHEAHC82I QR CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 60058 PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:425-252-4402 DAWN WEIMER CONTACT EMAIL:DAWN@GSHEATING.COM Existing Use of Building:RESIDENTAIL Contract Price of Work:$,�� 1 Of,� 'GO Proposed Use of Building:RESIDENTAIL Heat Source: WIGas ,®j=lectric ❑Other BUILDING USE: OSFR ❑Townhouse ❑Duplex EADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure Type of Project: ❑New ❑Addition EilRemodel ERepair ❑T.1. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: r-- , \vo , ASSOCIATED BUILDING PERMIT#(if applicable): .,.: :::MECHANICAL!PERMIT;APPLICATION S`::::' ::: PLUMBING PERMITsAPPLICATION :;; :(, ;; Fixture Fixture Fixture Fixture Count List of Fixtures coura List of Fixtures Count List of Fixtures Count List of Fixtures NC—Air Handling Units Gas Piping Backflow Preventer(Inside Bldg) Shower,Tub,or Combo Boiler Gas Range Clothes Washer Sink-Commercial(3-comp,prep,floor) Clothes Dryer 1 Heat Pump&Ductless Dishwasher Sink-Residential(kitchen,bath,bar) Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility,laundry,mop Exhaust Fans(Residential) Commercial Ventilatior Floor Drain Toilet Exhaust Hood(Type I) (Not Heat/AC system) Hose Bibb Urinal Exhaust Hood(Type II) Water Heater Interceptor-Grease Waste/Water Piping Repair Exhaust Hood(Residential) Wood Stove Interceptor-Sand/Oil Water Service(behind meter) i Forced Alr Systems Other: Medical Gas Water Valves or Fixtures Gas Fireplace/Insert/Log Roof Drains Water Heater ;'::SPRI NKLER I SUPPRESSION i;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!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 296.20CA WAC. City of Everett Official Use Only DAWN WEIMER `°°medbAWmasosWEIMER PE�� ` v '.- 0s-2--- Owner/41fi ;r >AgentSignature Date (Revised 10/10/2018)