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To: E Page 3 of 5 2016-03-14 20:58:53 (GMT) 18884000383 From: Deborah Shields <br /> • • <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/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:2227 127TH PL SE PROPERTY TAX#00921700000500 PERMI # <br /> f 1 -25' <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNERSTEVEN JANSEN Phone/E-mait425-337-0507 <br /> Address2227 127TH PL SE City/State/zipEVERETT, WA 98208 <br /> APPLICANT: Owner Owner's Agent _Contractor Contractor's Agent _Tenant(must provide a 6 tterof consent from the owner to do work in the space) <br /> CONTRACTOR Washington Energy Svcs Co, LLC iState Lic.#WASH IES851 NS City Bus. Lic.# 054773 <br /> Address 3909 196th St SW, Lynnwood, WA 98036 Phone/Ernail800-398-4663 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Jennifer Covello/jennifer@nwpermit.corn 206-774-9499 <br /> Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 43. 7 1710 <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gas , Electric Y Other <br /> Building type: lz�ingle Family Duple ownhouse '-Family Commercial <br /> Type of project: New Addition Remodel Re air T.I. Sign_Sprinkler Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> REPLACE GAS FURNACE AND INSTALL HEAT PUMP <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project Ne dd.W 4Iteration_,Repair Type of Project❑,Ne ddr Alteration_Repair <br /> Show Number # of fixtures Show Number # of fixtures <br /> A/C—air handling units Toilet <br /> Forced airs stems Bathtub <br /> Gas piping ; Lavatory wash basin <br /> I Water heater Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood ? Water heater <br /> I Exhaust fan Sink (service/bar/mop/etc.) <br /> Heat pumpBackflow preventer <br /> I Unit heater Urinal <br /> I Boiler <br /> Drinking Fountain <br /> i <br /> Refrigeration ' Floor drain <br /> Woodstove Grease trap <br /> DuctingRoof drains <br /> I Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM 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 hereln 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 art,Nu ,rd h r of this {pQ@y y to p�ric�rn��he�yvor�C for which application is made and 1 comply with the State Contractors Law 1827 RCW and 296.200AWAC. <br /> DN :,=Je f-, <br /> einail-)e <br /> wi este-iv�e,rrtco.n e=u5 03I14/2016 <br /> 2;¢: DOIQ.2eQ 1C 412:, -CAUU <br /> Owner/Authorized Agent Signature Date <br /> (Revised 9/2094) <br />