2816 104TH PL SE 2019-08-14 - 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 I FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION p PROJECT SITE ADDRESS: t(Q l()Li �� PROPERTY TAX#: O \9 ( 3Q.1 ®ISW LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: (7-10..PA, \(y, gX ( &IA Q e I TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET `)._ 1j D �U-t± CrrY � - STATE WA ` ZIP 982t OWNER PHONE: jtp-sj0y��-I Li-Q OWNER EMAIL: CONTRACTOR NAME:GS HEATING CONTRACTOR ADDRESS: sTREET3409 EVERETT AVE 0, EVERETT STATE WA ZIP 98201 CONTRACTOR PHONE:425-252-4402 CONTRACTOR EMAIL:INSTALL@GSHEATING.COM CONTRACTOR LICENSE#(REQUIRED):GSHEAHC821 QR CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 60058 PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR 0 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:$2000 Proposed Use of Building:RESIDENTAIL Heat Source: OGas ❑Electric ❑Other BUILDING USE: DSFR ❑Townhouse ❑Duplex EADU EMulti-Family-#Units: Commercial ❑Accessory Structure Type of Project: ❑New ❑Addition ❑✓Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition EChange of Use DESCRIPTION OF WORK: REPLACE GAS FURANCE ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Fixture Fixture Fixture Fixture Count List of Fixtures Count List of Fixtures Count List of Fixtures Count - List of Fixtures A/C—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 Heat Pump&Ductless Dishwasher Sink-Residential(kitchen,bath,bar) Duct System(Remodel) Refngeration Drinking Fountain Sink-Utility,laundry,mop Exhaust Fans(Residential) Commercial Ventilation 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) 1 Forced Air Systems Other. Medical Gas Water Valves or Fixtures Gas Fireplace/Insert/Log Roof Drains Water Heater SPRINKLER 1 SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other: Water Suppression System - Na of Heads Chemical Suppression System 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.lam the owner,or!an,authorized by the owner of this property to perform the work for which application is made, and/comply with the State Contractors Law 18.27 RCW and 296,200A WAC. City of Everett Official Use Only PERMIT DAWN I DIptally Waned6 DAWN WE MEa 7 �1 \ 1 Owne Auhd? d%AgentSignature exme.ee.oToo oaaar ^^11 Date (Revised 10/10/2018)