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9 0 <br /> PERMIT APPLICATION <br /> BUILDING / MECHANICAL 1 PLUMBING / SIGN /SPRINKLER / DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 1 FAX 425-257-8857 i(E)everetteps@everettwa.gov I www.everettwa.govipermits <br /> .r <br /> PROJECT SITE INIFIIJRA � ll� <br /> PROJECT SITE ADDRI_SS:401 Veralene Way SW PROPERTY TAX#:00708000006000 <br /> LEGAL for new construction: Short Piat!subdivision,.„__ t,ot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Michael lunge TENANT NAME(if Commercial): <br /> OWNER MAILING ADDRESS: STREET401 Veralene Way SW <br /> Crry Everett STATE WA ZIP 98203 <br /> OWNER PHONE:425-418-4082 OWNER EMAIL: <br /> CONTRACTOR NAME:WASHINGTON ENERGY SERVICES <br /> CONTRACTOR ADDRESS: STREET 3909 196TH ST SW <br /> CITY LYNNWOOD STATE WA ziP 98036 <br /> CONTRACTOR PHONE:206-378-6927 CONTRACTOR EMAIL:eonat@washingtonenegy.com <br /> CONTRACTOR LICENSE#(REQUIRED):WASHIES851 N5 CITY OF EVERETT BUSINESS LICENSEff(REQUIRED): 54773 <br /> PRIMARY CONTACT: ❑ OWNER Z✓ CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:206-378-6927 <br /> Ethan O n at CONTACT EMAIL:eonat@washingtonenergy.com <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Buildin :111 Single Family Residence- Detached lContract Price of Work:X1,500.00 <br /> Proposed Use of Building: Heat Source: ❑Gas ❑Electric DOther <br /> BuildingType: SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Farnil -#of Units: ❑Commercial ❑Industrial <br /> Ty e of Project: ❑New ❑Addition ❑Remodel ❑Re air ❑T.I. []Sign ❑S rinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: Replacing gas water heater <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New Addn _Alteration Repair Type of Project: _New _Addn _Alteration _Repair <br /> ffi <br /> #of List of Fixtures <br /> List of Fixtures #of List of Fixtures #of List of Fixtures Fixtures <br /> Fixtures FixturesAtC—Air Handlin Units Heat Pump ToiletBackflow Preventer{Inside Bldg) <br /> Forced Air Systems Unit Heater Bathtub Urinal <br /> Gas Pipin Boiler Lavato (WashBasin) Drinkin Fountain <br /> Water Heater Refrigeration Shower Floor Drain <br /> Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease rap <br /> Gas Ran e Ducting Dishwasher Roo`Drains <br /> Clothes Dryer Hookups Other: Clothes Washer Medical Gas <br /> Range Hood Water Heater Other: <br /> Exhaust Fan Sink(Service/Ear/Mop/etc.) Other <br /> SPRINKLER I S # 610N TIEM <br /> NI,irTibet of Heads <br /> ACI<NOWL.F-DGEMENT.1 have reviewed this application and confirm the information contained herein is true and correct Wortr done pursuant to this permit must comply with <br /> current federal,state,and!oral law. The granting of a permit only authorizes approved work and no deviations therefrom Deviations must first be authorized in writing from the <br /> Building Official before beir,,y authorized under any circumstance 1 in the owner,or i am authorized by the owner of this property to perform the work for which application is made, <br /> and I comply with,the State Contractors Law?8.27 RGW and 296.200A WAC <br /> City of Everett Official Use Only <br /> PEM � <br /> 08/17/16 <br /> pwnertAuthodzed�Aqent1r a Date (Revised tf�tdt Qt z) <br />