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� PERMIT APPLICATION . <br />BUILDING / MECHANICAL / PLUMBING / SIGN / SPRINKLER I DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, V�lA 98201 <br />(P) a25-257-8810 ( FAX 425-257-88,57 �(E) �veret���s��ve+atEw�t.c�t�v ( www.everettwa.govlpermits <br />i� <br />� � ������� ���r���������xQ <br />'�°���� ���c �°������623 1 Q4th PI SE �'�a����"� �"aX #'00389500000200 <br />_EGAL for new canstruction: Short {"i�fl5ui�s��visic�n _, . LaS No. (attach copy of long legal description) <br />r�E� N,amE: Verian Wilkie <br />TENANT NAME (If <br />WNER MAILING ADDRESS: sraeeT623 � O4ti1 P) SE <br />�,TY Everett <br />WNER PHONE:42�J-76�-92-92 OWNER EMAIL: <br />ONTRACTOR NAME:rNASHINGTON ENERGY SERVICES <br />ONTRACTOR ADDRESS: srReer 3909 196TH ST SW <br />:-��.T� WA <br />Z,� 98208 <br />cirv LYNNWOOD sr,vre WA z�P <br />ONTRACTOR PHONE: 206-378-6927 CONTRACTOR EMAIL: e0nat@washingtonenegy.com <br />QNTRACTOR LICENSE #(REQUIRE`Qj; WASHIESBS'I NS CtTY OF EVERETT BUSINESS UCENSE t1{R�QUt <br />�1MARY CONTACT: ❑ OWNER �✓ Gt7hlTRACT(JR ❑ OTHER (Please Specify) <br />ONTACT NAME: CC7NfiACT PHONE:206-378-6927 <br />Eth a n O n at �CQ�ITAGT EMAIL: eonat@washingtonenergy cam <br />of <br />se of auiE�iin :111 Single Family Residence - Detached Crsntract Price of Work: $1,soo <br />Use of Building: Heat Source: ❑Gas ❑Electric <br />��e 5FR Detached �SFR-Atiached CaDu�lex ❑Multi-Famiiy-# of Units; ❑� <br />oject ❑New ❑Addition ❑Remodel ❑Rspair ❑T i. C��I n ❑Sprinki�sr ❑Demolition <br />rioN oF woRK: Replacing gas water heater <br />BUILDING PERMIT #(if <br />98036 <br />54773 <br />❑Other <br />>mmercial ❑Industrial <br />❑Ghan�e of Use <br />ACKNOWLEDGEMFN7 ! have rewewed fhis application and confirm the irrtormafion contained herern is true and correct Work da�e pursuan! to th7s permit must comply wifh <br />c�rrent federat, sra(ca, and Joc�l faw 7re granfing nf a peimii onty authonzes approved work and no deviafions there/rom. Deviations must (�st Ge authonzed in wnting from the <br />Biotdint� U(rcial betorn peir�q authonzed under any circumstance 1 am !he ewner, or ! am authonzed by the owrer ol this properfy to per*"orm, the, work !or v.�hich aApiicatron is rnade, <br />ond i comply wi�h thca St��te f,ortracto�:s L'a�v t8 27 RC'JV 8nd 296,2COF WAC. <br />City nf F..vereft Urfrclal L�se Only <br />� �, PF -IT# <br />/ <br />_ "� e�` Otl116176 <br />, �, , � <br />_�,� � <br />OwnertAutAtarrr4c Ac�:r�T�i��ena �t� " � � � � tl�te (f?�s�i��.�1��CI9�';<<:?;">1 <br />