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To: E Page 2 of 4 2015-08-06 16:12:41 (GMT) 18884000383 From: Deborah Shields <br /> 40 0 <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:5024 DOGWOOD DR PROPERTY TAX#004422000012001 P <br /> , — <br /> LEGAL_for new construction: Short PlaVeub division Lot No. (attach uopy of long legal descripticn) <br /> OWNERCARROLL TIEDE PhcnelE-maii425-259-1005 <br /> Address5024 DOGWOOD DR City,'sta;Pi ir,EVERETT, WA 98203 <br /> APPLICANT:_Owner ^Ovo-rer's Agent ._Contractor Gontracror's Agent ,_Tenant lmuat prevido a letter of con,enl f,vm tiw owr W do vvrk in the space', <br /> CONTRACTOR WESCO state Lic.#WASHIES971 OB city Bus. Lic.#41349 <br /> Address 3909 196th St SW PhonerEwiall 800-398-4663 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> JENNIFER COVELLO 206-7741-3499 JENNIFER@iNWPERtd IT.CON4 <br /> PhonelF-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRIGE OF WORK 10003.00 <br /> Existing Use of Building Res HEAT SOURCE: <br /> Proposed Use M "l <br /> Gas Electric, ott,ar <br /> Building type: ingle Family Duple owihause Family ommercie( <br /> Type of project: New Addition Remodel Re air f.€. Sin_Sprinkler Demolition Chane of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> REPLACE GAS FURNACE,INSTALL HEAT PUMP <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New�Addn ZIteration_Repair Type of Project: _New�Addt Iteration_Repair <br /> Show Number # of fixtures Show Number # of fixtures <br /> I A1C—air handling units Toilet <br /> L Forced airs stems Bathtub <br /> Gas pipingLavatory wash basin <br /> Water heater Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood Water heater <br /> Exhaust fan Sink 'servicelbartmo tete. <br /> ' Heat purnpBackflow preventer <br /> Unit heater _ Urinal <br /> Boiler <br /> Drinking Fountain <br /> Refrigeration ; Floor drain <br /> Woodstove Grease trap <br /> Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM <br /> Other: <br /> Number of Heads Other: <br /> I hereby certify th,t I have read and examined this appliration and know the sams 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 a,Ahorty to violate or cancel the provision of any other state or lor..al law regulating;or wruction <br /> That;am authorized by the owner of tlFiis property to periform the work fur which application is;made and I comply with the Stats Contractors Law 18.27 RCW and 296.2r010A WAC, <br /> Jennifer Covello $16/15 <br /> Owner/Authorized Agent Signature Date (Revised 9,12014) <br />