5030 27TH AVE W 2019-08-08 - Laserfiche WebLink

PPz/4./—_ PERMIT APPLICATION BUILDING I MECHANICAL/PLUMBING/SIGN/SPRINKLER/ DEMOLITION CITY OF EVERETT PERMIT SERVICES a a 3200 CEDAR STREET,EVERETT,WA 98201 (F)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.govtpermits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: \ C) 4i I , , `kiPROPERTY TAX#: V i) itc-Z ;, LEGAL for new construction: Short Plat/subdivision 'Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: \- f1 A-'r\A.in,( 4;,LI ..nc--- TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET Ci)?—yr) ./7-1-. , • ,;,..,Lr) CITY t-''7 511,HLP STATEI j.., ZIP P1 Kb OWNER PHONE: 't,,j t\_ga M \1 z v" OWNER EMAIL: CONTRACTOR NAME: G&S HEATING CONTRACTOR ADDRESS: mem- 3409 EVERETT AVE crry EVERETT STATE WA ZIP 98201 CONTRACTOR PHONE: 425-252-4402 CONTRACTOR EMAIL: DAWN@gSHEATING.COM CONTRACTOR LICENSE#(REQUIREW): GSHEAC*939RK CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 019685 PRIMARY CONTACT: ❑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:$ 7,fir'(' Proposed Use of Building: RESIDENTIAL Heat Source: ❑Gas Electric ❑Other Building Type: LKSFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial [Industrial Type of Project: ❑New ❑Addition ❑Remodel nRepair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition OChange of Use DESCRIPTION OF WORK: Ir.i , °�-�kiC,12 c \firek j l\-, J-', ' y , ..317c- ,),}A-)1? ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APICATION PLUMBING PERMIT APPLiCATiiON Type of Project: _New_ Addn Alteration Repair Type of Project: New _Addn _Alteration _Repair #of List of Fixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures Fixtures Fixtures Fixtures Fixtures A/C–Air Handling Units 1 Heat Pump Toilet Backflow Preventer(Inside Bldg) ti 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 don&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 1 comply with the State Contractors Law 16.27 ROW and 296.200A WAC. ( City of Everett Official/�Use Only //----\,....__ i;^ PEI 1 2 -l/v/ Owner/Authorized Agent Signature bate ` (Revised 9/23/2016)