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0 0 <br /> PERMIT APPLICATION <br /> BUILDING / MECHANICAL/ PLUMBING I SIGN / SPRINKLER / DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 FAX 425-257-8857 1(E)everetteps@everettwa.gov l www.everettwa.gov/permits <br /> PROJECT SITEINFORMATION <br /> PROJECT SITE ADDRESS: 5502 College Ave PROPERTY TAX#: 00443200004200 <br /> LEGAL for new construction: Short Ptat/subdivision__._ Lol No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Alien Schei TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 5502 College Ave <br /> c1Ty Everett STATE WA 21P 98203 <br /> OWNER PHONE: 425-422-3620 OWNER EMAIL: <br /> CONTRACTOR NAME: Washington Energy Services <br /> CONTRACTOR ADDRESS: STREET 3909 196th St.SW <br /> CITY Lynnwood STATE WA zip 98036 <br /> CONTRACTOR PHONE: 206-378-6927 CONTRACTOR EMAIL: JCopley@washingtoneriergy.com <br /> CONTRACTOR LICENSE#(REQUIRED): WASHIES85I NS CITY IF EVERETT BUSINESS LICENSE#(RECIUIRED9, 54773 <br /> PRIMARY CONTACT: ❑OWNER ®CONTRACTOR ❑OTHER(Please Specify) �.. _.. <br /> CONTACT NAME: CONTACT PHONE: 206-378-6708 <br /> Joyce Copley CONTACT EMAIL: JCopley@washingtonenergy.com <br /> AUII.011,"O PERIIkfIT APPLICATION, <br /> Existing Use of Buildin : Contract Price of Work:.$ $1500 <br /> Proposed Use of Building: Heat Source: ®Gas ❑Electric; ❑Other <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Du lex ❑Multi-Family-#of Units:_- ❑Commercial 11 Industrial <br /> Type of f'r*ct: ❑New ❑Addition ❑Remodel ❑Re air ❑T.L 135i n ❑Sprinkler, ❑Demolition ❑Chan a of Use <br /> DESCRIPTION OF WORK: <br /> Replace gas water heater <br /> ASSOCIATED BUILDING PERMIT#(if applicable):. <br /> MECHANICAL PERMIT APPLICATION PLUMOING*PERMIT APPLiCATiON <br /> Type of Project: _New , Addn _Alteration X Repair Type of Project: _New _Addn _Alteration _Repair <br /> #of List of Fixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> A/C—Air Handling Units Heat Pump Toilet Backflow Preventer(inside Bldg) <br /> Forced Air S stems Unit Heater Bathtub Urinal <br /> Gas Piping Boiler Lavatory(Wash Basin) Drinking Fountain <br /> X Water Heater refrigeration Shower Floor Drain <br /> Gas Fire Ease Wood Stove Kitchen Sink&Disposal Grease ira <br /> Gas Ran e Ductinq Dishwasher Roof Drains <br /> Clothes Dryer[lookups Other: Clothes Washer Medical Gas <br /> Ran e Hood Water Heater Other: <br /> Exhaust Fan Sink Service/Bar/Mopietc. Other: <br /> SPRINKLER/SUPPRESSION SYSTEM <br /> Number of Heads <br /> ACKNOWLEDGEMENT i have reviewed this application and confirm the infortnation contained hetein is true and correct.Work done pursuant to this permit mull comply with <br /> currenl 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 t am authorized by the owner of this property to perform the work for which application is marfe, <br /> and 1 comply with the State Contractors Law 18.27 RCW and 296,200A WAC. <br /> PERc;iN of Everelt Official t.lse Only <br /> 144 T# . �.....,. ��� <br /> D�r alb <br /> Cowl)lf.11thetriz Agent Signature <br /> (R <br /> I:}ata evised 10/ 15) <br /> t2!C1 <br />