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� <br />� <br />`�M��� <br />• <br />• <br />PERMIT APPLICATION <br />BUILDING 1 MECHANICAL t PLUMBING / SIGN / SPRINKLER / DEMOLITION <br />CITY dF EVEREl-T PERMIT SERVICES <br />3200 CEDAR 5TREET, EVERETT, WA 98201 <br />(P) 425-257-881(7 I FAX 425-257-8857 �(E} e�er'r�tt� g;(c���t�r�ttw�.c�+;��i � evww.everettwa.gov/permits <br />�C+�i <br />WNER NAME: Roger Hauy <br />WNER MAILING ADDRESS: sTaeer 1120 Rucker Ave <br />�iTM Everett <br />WNER PHONE: 425-252-0152 <br />ONTRACTOR NAME: Wa�#zitu�tdn Energy Services <br />�a���znn��-��r� <br />TENANT NAME ([f Comme <br />�WNER EMAIL: <br />sr,aie WA <br />ziv <br />CONTRACTOR ADDRESS: srkeer 39Q9 196th SL SW <br />cirr L n�wo0d s?r�TE WA zi. 98036 <br />CONTRACTOR PHONE: 206-378-6927 CON7RACTOR EMAIL: �Copley@washinglonenergy.com <br />CONTRAC70R LICENSE #(REQUIRED): WASHIES851NS CITY OF EVERETT BUSWESS LICENSE#{R�CtUlRED): 54773 <br />PRIMARY CONTACT: � OWNER � CONTRACTOR ❑ OTHER (Please 5pecify) <br />CONTACT NAME: CONTACT PHONE: 206-378-6708 <br />Joyce Copley CONTAGT EMAIL: JCopley@washingtonenergy.com <br />�i„�1 <br />xistinc� Uue of F�uil�tir���: <br />rc�pra;�z�cf Use of E3uiitlirr�: <br />uildinq Tvpe: ❑SFR-Detached ❑SFR-Attached <br />ype of Project: ❑New �Addition ❑Remodel ❑ <br />ESCRIPTION OF WORK: <br />Replace gas water heater <br />�onfract Price of Work: � $1200 <br />Ne�at Source: �Gas ❑Electric ❑Cithar <br />rlex ❑Multi-FamilV-# of Units: ❑Commercial ❑Industrial <br />r ❑T.I. ❑Siqn ❑Sprinkler ❑Demolition ❑Chanye of Use <br />�ASSOCIATED BUILDING PERMIT #(if applicable): l <br />/tCKNCW[ EDGEM[NT: � have reviev�ed lhis applir,ation and confirm fhe inloimalion contained herern rs true and ccrrec[ Work dane pursuant io this perrnil rnusl comply wrth <br />currer,! t,r,fnr�.3r. tit.�ate, dn�( nc�! tav,� 71m �i;�t�lrn �_,t o perrr�if enfy authnn[t��.s af?prcvsd ove�rH ;ar�d no devi�(inr, : tt crr_,ti�orrG. L-�i;lrens ���_ zt fi,st b, aeNhorized in wri(rng /ram if;n <br />�uirdi +y U i�ci,�x1 t r,1�:r�N Lairrg eYi.dhrr,rzatl �.,n.tc+ an� cir�;ilm5::��,cs?. i ar'i ihe ow�te�, u�-i am atell�+orizeti i�)� thc cwnc� ..)/ t1,is pr;�peRy tc� );<;rlwrn !hc wo,�1� fi�r wt�r� tr 3pp�,^atior. Is rrr,dl�:, <br />.7i,u' $^r"s� ���':i;� V,�r( � itF� .:>ft�t, � �ct.,. m,v !r3 i rGbV <s �_i� Jh(�k �Vf�C: <br />��, � � �� d: dF d Fw-re.t� �� u�'at l.a.; t:�r.1,• <br />� ,�`� � F'F_{�t:dill # <br />�� � �� � � �� ��� �� ��� ._,� � � � <br />t_... � _,€' r .�.__4����__��� f F ! <br />CT � �f6#u tr i�r;! Agent �{�natijFr, D' � �� ( 2�.��, r J/l�zJ�isi 3j <br />