8823 10TH DR SE 2017-01-13 - Laserfiche WebLink

PERMIT APPLICATIOIV 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/permils PROJECT SITE INFORMATION PROJECT SITE ADDRESS:8823 � Otil Df SE PROPERTY TAX #:0073� OOOOOZ�JOO LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: AI"Ill@ AI�@tS TENANT NAME (If Commercial): OWNER MAILING ADDRESS: srREEr8823 10th Dr SE �„�, Everett STATE WA Z,P 98208 OWNER PHONE:425-353-33HO OWNER EMAIL: coNTwacTOR NannE:WASHINGTON ENERGY SERVICES CONTt�,aCTOR ao�REss: sTREET 3909 196TH ST SW �,�, LYNNWOOD STATE WA Z,P 98036 CONTRACTOR PHONE:2O6-37H-664S CONTRACTOR EMAIL:deagl@@WaSI1111gt011@118gy.001'll CONTRACTOR LICENSE #(RECIUIRED): 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 PERMIT APPLICATION Existing use of Buiiding: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 muplex ❑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 licable): PLUMBING AERMIT APPLiCAT101N 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. 1 have reviewed this application and confirm the information contained herein is true and correct. Work done pursuant to this permit must comply with current federal, state, and local law. The granting of a permit only authorizes approved work and no deviations therefrom. Deviations must first be authorized in writing from the Bui/ding 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 1 comply with the State Contractors Law 18.27 RCW and 296.200A WAC. DeAnna Eagle � -� � ia�ai�s Owner/Authorized Agent Signature Date City of Everett Official Use Only PERMIT# ��o v ��n 1 (Revised 10/12/201 )