5011 27TH AVE W 2017-01-13 - Laserfiche WebLink

PERMIT APPLICATION BUILDING / MECHANICAL / PLUMBING / SIGN / SPRINKLER / DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P) 425-257-8810 � FAX 425-257-8857 �(E) everetteps@everettwa.gov � www.everettwa.gov/permits PROJECT SITE INFORIIAATION PROJECT SITE ADDRESS:5O'I � 2%tIl AV@ W PROPERTY TAX #:005679OOZOO6OO LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: KflStj/ MCDOIIaICI TENANT NAME (If Commercial): OWNER MAILWG ADDRESS: srREeT5011 27th Ave W �„� Everett STATE WA Z�P 98203 OWNER PHONE:4Z5-923-O95H OWNER EMAIL: COtvTRACTOR NAME:wASHINGTON ENERGY SERVICES CONTRACTOR ADDRESS: srReeT 3909 196TH ST SW cin LYNNWOOD STATE WA ZiP 98036 CONTRACTOR PHONE: 206-378-6927 CONTRACTOR EMAIL: eonat@washingtonenegy.com CONTRACTOR LICENSE #(REQUIRED): WASHIES851 NS CITY OF EVERETT BUSINESS LICENSE #�REQUIRED): 54773 PRIMARY CONTACT: ❑ OWNER �CONTRACTOR ❑ OTHER (Please Specify) CONTACT NAME: CONTACT PHONE:206-378-6648 DeAn na Eag le CONTACT EMAIL: deagle@washingtonenergy.com BUILDING PERMfT APPI.ICATION Existin Use of Buildin :111 Single Family Residence - Detached Contract Price of Work: $1500 Proposed Use of Buildin : Heat Source: ❑Gas ❑Electric ❑Other Buildin T pe: �SFR-Detached ❑SFR-Attached mu lex ❑Multi-Famil -# of Units: ❑Commercial ❑Industrial T e of Pro ect: ❑New ❑Addition ❑Remodel ❑Re air ❑T.I. ❑Si n ❑S rinkler ❑Demolition ❑Chan e of Use DESCRIPTION OF WORK: Replacing gas water heater ASSOCIATED BUILDING PERMIT # if a plicable : MECHANICAL PERMIT APPLICATION Type of Project: _New _ Addn ✓ Alteration _Repair Fixtures List of Fixtures Fixtu es List of Fixtures A/C — Air Handling Units Heat Pump Forced Air S stems Unit Heater Gas Pipin Boiler � Water Heater Refri eration Gas Fireplace Wood Stove Gas Ran e Ductin Clothes D er Hooku s Other: Ran e Hood Exhaust Fan SPRINKLER ! SUPPRESSION SYSTEM Number of Heads PLUMBING PERMIT APPLICATION Type of Project: _New _Addn Iteration _Repair # of List of Fixtures # of List of Fixtures Fixtures Fixtures Toilet Backflow Preventer (Inside Bld ) Bathtub Urinal Lavato (Wash Basin) Drinkin Fountain Shower Floor Drain Kitchen Sink & Disposal Grease Trap Dishwasher Roof Drains Clothes Washer Medical Gas Water Heater Other: Sink Service/Bar/Mo /etc. Other: ACKNOWLEDGEMENT: I have reviewed this application and confirm the information contained herein is true and correct. Work done pursuant to this permit must comply with cunent federal, state, and local law. The granting of a permit only authorizes approved work and no deviations therefrom. Deviations must first be authorized in wrifing from fhe Building Official before being authorized under any circumstance. I am the owner, or I am authorized by the owner of this property to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. DeAnna Eagle - � - � osi�ai�s Owner/Authorized Agent Signature Date City of Everett Official Use Only PERMIT # ,�, n �,� �� , (Revised 10/12/2015)