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• PERMIT APPLICATIO�
<br />BUILDING / MECHANICAL / PLUMBING / 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 �(E) everetteps@everettwa.gov � www.everettwa.gov/permits
<br />PROJECT �tT� 1l+1�t�IFtM#iT'i41�i
<br />PROJECT SITE AD�RES�: 1710 Rucker Ave P�����7� TA� �' 00438034402700
<br />LEGAL for new construction: Short Pia��'subdivisic�r� l �51 No. (attach copy of long legal description)
<br />rr�ar�Tiai+r'r' �r������"�`��}%�
<br />OWNER NAME: �aVld L22 TENANT NAME {If Commercial}.
<br />OWNER MAILING ADDRESS: srREer 1710 Rucker Ave
<br />CITY EVerelL STATE • �� ZIP 98201
<br />OWNER PHONE:4253436188 OWNER EMAIL:
<br />CONTRACTOR NAME:WASHINGTON ENERGY SERVICES
<br />CONTRACTOR ADDRESS: srREET 3909 196TH ST SW
<br />�,n LYNNWOOD sTArE WA ,,;> 98036
<br />CONTRACTOR PHONE: 206-378-6927 CONTRACTOR EMAIL: eonat@washingtonenegy.com
<br />CONTRACTOR LICENSE #{R�(�UIF2�L7;: WASHIES851 NS CITY OF EVERETT BUSINESS LICENSE �'(REQUIRED): 54T73
<br />PRIMARY CONTACT: ❑ OWNER �CONTRACTOR ❑ OTHER (Please Specify)
<br />C�NTACT NAME: C('?i�TACT PHONE: 206-378-6927
<br />Eth a n 4 n at ���y�;qGT EMAIL: eonat@washingtonenergy.com
<br />' BUNLt1�lN+� P��N11T i�P�M ���'����
<br />Existin� Use of Huilding: Contract Price of Work: $
<br />F'ropased Use of Buifdin : Heat Source: ❑Gas ❑Electric ❑bther
<br />Building T p� ❑SFR-Detached ❑SFR-Attached ❑D��pinx ❑Multi-Family-# of Units: ❑Commercial ❑Industrial
<br />i p� of Prcaject ❑New ❑Addition ❑Remodel ❑Re{�air OT.I. ❑Si n ❑S�rinkler ❑Demolition ❑Ch�n e of Use
<br />DESCRIPTION OF WORK:
<br />Replacing furnace and Heat Pump. Like in kind electric furnace and
<br />heat pump.
<br />AS50CIATED BUILDING PERMIT # (if applic:at�lej
<br />MECHACVICAL P�RMIT APPLICATION
<br />Type of Project: New Addn Alteration _Repair
<br />Fixtures Lisf of Fixtures Fi xu es ��st of Fixtures
<br />A/C — Air Handling Units � Heat Pump
<br />Forced Air Systems i Unit Heater
<br />Gas Pipin Boiler
<br />Water Heater Refrigeration
<br />Gas Fireplace ` Wood Stove
<br />Gas Ran, e Ducting
<br />Clothes Dryer Hookups Other.
<br />Range Hood
<br />Exhaust Fan
<br />SPRINKLER ! �UN��Ir��SS1C�N S�*STEM
<br />Nursik°r�i ��( 1 #�aeis
<br />P.�,f;fuC?��7 P,J�: ZPAL�Ov�` ,' ?1tai�., ..�,�,�F J It��S r;pptir;aiion and cor6nr, fhn ;n�or,nat;un centdined herein is true �n�� a7rrect_ vVork done t�ursuar,t �o fhi,s,�erntit musi cr;rr,�frty �.v�th
<br />r,, �.; at te�r�raL state a�,�7loca: .a�.�- r�„e yrart;ii�y or ��;errrsit or�ly authc r,zr..:; approved v✓or'K rnti no devi�,fre�r;s ,%?ereTrona utav�atri�n; trutst fi„t be at�Pi�nr1'r.ad in �� it� u ho?rt �he
<br />F,riteJrng ��;d c;a, a;rc -� .^.e �r, a�rtncrt�ra,• �.,�tler a"y c; cirr.rs���zce ; am ,Y,� .,wr �r or' t a�n duthonzed f;y� the o�.vr�e�' of th�s �„c;uerfy to p��,`om� the v��oru for �vt�lch aoaircatrcti� ,..
<br />a�. C+ 1 �or,r,�r, � �:fh �+r� � ,+c- ��o <�� �:>r�t . _ ' H .?7 t . 4�v' anii . �f ?QU�I V.�'t; �"
<br />^;,�c; E�r,.�.... �.i�!a�� c,se �'3fsty
<br />�°� PERNIIT #
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<br />C7wnertAuthctrized d4� �,t Si natare �}�tc {t��ev;;ed 1��i? �`r?7,�d
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