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� <br />� <br />PERMIT APPLICATION <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 h25-257-8857 �(E) everetteps@everettwa.gov j www.everettwa.gov/permits <br />F�Ri'lJ�CT` StTE 11+#�CtR�IiA'i1liN <br />DJECT SdT� AC�f7RESS:S�r��J �V�i"�1'E.'E.'il UV��% PRdPERTY TAX #:OO� 4738 <br />3AL for rew construction Short PlaUsubdivision Lo' Na ;at',ach copy o` long leaal description) <br />rGtJ�1d'f�4�'�" 11�i��iRtV11�'C"iCi�sl <br />INER NAME: LOS POtC'IIIOS TENANT NAME {if Commercial}: AbfBllalll Ra17111'EZ <br />INER MAILING ADDRESS: srReeT8825 EV@f�fe@11 <br />;;T� Everett G;:,rr WA Z,� 98208 <br />fNER PHONE:425-26�J-'I 'I7� C)W#VER EMAiL: <br />CONTRACTOR N,4ME:WASHINGTON ENERGY SERVICES <br />CONTRACTOR ADDRESS: srREET 3909 196TH ST SW <br />�,TY LY N N WOO D �-A.T� WA Z�P <br />CONTRACTOR PHONE: 206-378-6927 CONTRACTOR EMAIL: eonat@washingtonenegy.com <br />CONTRACTOR LICENSE �lqR�t2UtREp)i wASHIES851 NS �17Y OF EVERETT BUSINESS uCENSE #{IRGQtit <br />o y. .. . .. ..... . .. <br />PRIMARY CONTACT: O OWNER �CCJNTRACTOR ❑ OTHER (Please Specif ) <br />CONTACT NAME: CONTACT PHONE; 206-378-6927 <br />E lh a n lJ n a t CONTACT EMAIL: eonat@washingtonenergy.com <br />n Use of Buildtn :��titlt� PI2C@S {F2�S��i��'�IItS) Contract Price of Work: $$,500 <br />�sed Use of Buildin : Heat Source: ❑Gas ❑Electric <br />ri� Type: ❑SFR-Detached ❑S�R-Attached ❑�tu f�x ❑Multi-Farstil -# of Units: <br />of F�rpt�ct_ ONew ❑Addition ❑Remodel R��ait ❑T.L �Si n ❑Spr <br />:RIPTION OF WORK: <br />Rasplacing gas water heater <br />TED BUILDING PERMiT # <br />❑Demolition <br />a:� . <br />54773 <br />ommercial ❑Industrial <br />❑Chancte of Use <br />ACXh�OUJLFC7Cd6L1FNT i have revirsved this apptication and confirm Lhe ir,formatron contained herein is tru= an0 correr,l. Work done pursuarrt to fhis pemii! rnust Compty with <br />current fedeial, srate, arrd local /aw. The grantmy of a permif anly aufhonzes approv�d v�cnc and no devrations therel�orn Devialrurs most frrst oe auihonzed in wrilina �rom tha <br />f?v�tUh�g i11f,c;a! !.>eiore berng auihenzed under any circums!a+�ce ; arn the ow+ler, nr f arn au(herrted by !he o�vner el thi� properry to perlonr lhe wo�k for whici, upplicat�en is rnade, <br />aricr t complV �.vrth ti;e Sta?a Contrar.;ors Law 78 2? RCvV and 29F; 200A WAC <br />City ot F_verett Offcia! Use Gnly <br />� r""� '� : �.�E; C� `VI T #� <br />l � �---�� <br />��j'����,� � � o8„s�,6,�..____�__. L ����G���� � � <br />i'�wneer1AA34hcsr zr. ��+ant .. i{arrtt[ure Da[e �Revis:d rd��t6E2t7J�j <br />.�� • � � <br />