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To: E Page 2 of 4 2016-03-11 18:17:18 (GMT) 18884000383 From: Deborah Shields <br /> is 9 <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBINGISIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> SITE ADDRESS: 1 803 125TH PL SE PROPERTY TAX it 00399300000600 PE M T 11 <br /> LEGAL for new construction: Short Plat!subdivision Lot No. (attach copy of long legal description) <br /> QWNERGREG LAMBERT Phone/E-mail 206-852-6342 <br /> Address 1803 125TH PL SE City/state/Zip EVERETT, WA 98208 <br /> APPLICANT:_Owner Owner's Agent _Contractor ✓ Contractor's Agent _Tenant(must provide a ietterof consent from the a�nryr to do work in the space) <br /> CONTRACTOR Washington Energy SVCS Co, LLC state Lic.#WASH ES851 NS City Bus. Lic.# 054773 <br /> Address 3909 196th St SW, Lynnwood, WA 98036 Phone/Email8OO-398-4663 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Jennifer Covello/jennifer@nwpermit.com nwpermit.com 206-774-9499 <br /> Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 53820Q <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gas I Electric Y I Other <br /> Building type: [�$ingle Family Duple ownhouseFamily Commercial <br /> Type of ro'ect: New Addition Remodel Re air Y/ T.I. Sin Sprinkler Demolition Chane of Use <br /> DESCRIPTION OF WORK(additional space provided on lite back): <br /> INSTALL HEAT PUMP <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project. Ne ddn Z/ Iteration_Repair Type of Project NeH ddr Alteration_Repair <br /> Show Number # of fixtures Show Number # of fixtures <br /> A/C—air handling units Toilet <br /> o Forced airs stems Bathtub <br /> p Gas pipinc ! Lavatory wash basin <br /> ! Water heater Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> i Clothes dryer ' Clothes washer <br /> Range hood Water heater <br /> Exhaust fan Sink (service/bar/mop/etc.) <br /> Heat pump Backflow preventer <br /> Unit heater Urinal <br /> M Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> I Ducting Roof drains <br /> I Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM <br /> Other: <br /> Number of Heads I Other: <br /> I hereby certify that I have read and examined this application and know the same to be true and correct.All provisions of laws and ordinances governing this type of work will be comp <br /> with whether specified herein or not.The granting of a permit does not presume to give authority to violate or cancel the provision of any other state or local law regulating construction <br /> That I at lkznr. /fid;h Yd r of this RfJo <br /> y application is made and I com PY QQto ��rr m�t, or.for which a I with the State Contractors Law 113.27 RCw and 296.200A WAC. <br /> Y JfiJ�t•�nSh�Cwa, <br /> UN r-J�r ,E iWvei v <br /> \ ,LW l;r S` email-;ei llei ti2,wpern.t.uc..n c=U9 03/11/2016 <br /> S <br /> Owner/Authorized Agent Signature Date (Revised 9/2094) <br />