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PERMIT APPLICATION <br /> BUILDING / MECHANICAL / PLUMBING / SIGN / SPRINKLER/ DEMOLITION <br /> EVERETTCITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> WASHINGTON (P)425-257-8810 1 FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS:2201 36TH ST PROPERTY TAX#:00602700700402 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: EVERETT CREEK LLC TENANT BUSINESS NAME(Commercial): (141.01 •€c <br /> OWNER MAILING ADDRESS: STREET PO BOX 2819 U <br /> ci-rr KIRKLAND STATE WA ZIP 98083 <br /> OWNER PHONE: 206-948-6413 OWNER EMAIL:BRET@ROCKISLAND.COM <br /> CONTRACTOR NAME:GS HEATING& COOLING LLC <br /> CONTRACTOR ADDRESS: STREET3409 EVERETT AVE <br /> aTv EVERETT STATE WA ZIP 98201 <br /> CONTRACTOR PHONE:4258-610-4257 CONTRACTOR EMAIL:JONATHAN@GSHEATING.COM <br /> CONTRACTOR LICENSE#(REQUIRED):GSH EAHC821 QR CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 19685 <br /> PRIMARY CONTACT: 0 OWNER El CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:425-309-6507 <br /> JONATHAN D. FARRELL CONTACT EMAIL:JONATHAN@GSHEATING.COM <br /> BUILDING INFORMATION /� � "� e, 4 <br /> Existing Use of Building:NA Contract Price of WoYac• $4,0000.00L)U .D% <br /> Proposed Use of Building:NA Heat Source: ❑s Gas ❑Electric DOther <br /> BUILDING USE: ❑SFR ETownhouse ❑Duplex `jADU ❑Multi-Family-#Units: ✓❑Commercial ❑Accessory Structure <br /> Type of Project: New Addition ❑Remodel ❑✓Repair T.I.❑ ❑Sign Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: REPLACING UNIT HEATER WITH LIKE IN KIND UNIT <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Fixture Fixture Fixture Fixture <br /> Count List of Fixtures coeur List of Fixtures Count List of Fixtures Count List of Fixtures <br /> A/C—Air Handling Units 1 Gas Piping Backflow Preventer(Inside Bldg) Shower,Tub,or Combo <br /> Boiler Gas Range Clothes Washer Sink-Commercial(3-comp,prep,floor) <br /> Clothes Dryer Heat Pump&Ductless Dishwasher Sink-Residential(kitchen,bath,bar) <br /> Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility, laundry,mop <br /> Exhaust Fans(Residential) Commercial Ventilatior Floor Drain Toilet <br /> Exhaust Hood(Type I) (Not Heat/AC system) Hose Bibb Urinal <br /> Exhaust Hood(Type II) Water Heater Interceptor-Grease Waste/Water Piping Repair <br /> Exhaust Hood(Residential) Wood Stove Interceptor-Sand/Oil Water Service(behind meter) <br /> Forced Air Systems Other: Medical Gas Water Valves or Fixtures <br /> Gas Fireplace/InserULog 1 UNIT HEATER Roof Drains Water Heater <br /> SPRINKLER/SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other: <br /> Water Suppression System No.of Heads <br /> Chemical Suppression System No.of Heads <br /> 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 <br /> 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 <br /> 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, <br /> and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> �J� City of Everett Official Use Only <br /> Z7). Pa4A-d 5719 PERMIT#tA D'15- 07)2_ <br /> Own Authorized Agent Signature Date (Revised 10/10/201) <br />