321 72ND ST SE 2017-01-13 - Laserfiche WebLink

SITE • PERMIT APPLICATIO� BUILDING I 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 5�321 72nd St SE for new construction: Short PlaUsubdivision NFORMATIt�N r rax #:00402000000300 No. (attach copy of long legal description) CONTACT INPORMATION OWNER NAME: ROCI(I@ V811Cl2fpO0I TENANT NAME (If Commercial): OWNER MAILING ADDRESS: srReer321 72nd St SE �,n Everett STATE WA Z,P 98203 OWNER PHONE:42�J-Z9O-� O%3 OWNER EMAIL: cONrRACTOR NAME:WASHINGTON ENERGY SERVICES CONTRACTOR A��RESS: srReeT 3909 196TH ST SW cin LYNNWOOD sTnTe WA ziP 98036 CONTRACTOR PHONE: 206-378-6927 CONTRACTOR EMAIL: eonat@washingtonenegy.com CONTRACTOR LICENSE #(REQUIRED): WASHIES851 NS CITY OF EVERETT BUSINESS LICENSE #(REQUIRE : 54773 PRIMARY CONTACT: ❑ OWNER �CONTRACTOR ❑ OTHER (Please Specify) CONTACT NAME� CONTACT PHONE:206-378-6648 DeAn na Eag le CONTACT EMAI�: deagle@washingtonenergy com BUlLD1NG P�RM[T APPLlCAT10N Existin use of Buildin :111 Single Family Residence - Detached Contract Price of Work: $13894 Proposed Use of Buildin : Heat Source: ❑Gas ❑ ctric ❑Other Buildin T pe: ❑SFR-Detached ❑SFR-Attached �u 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: Installing a ductless heat pump ASSOCIATED BUILDING PERMIT # if a licable : � PL.UMBING P�RMIT APPLICATIQN Type of Project: New Addn Iteration _Repair # of List of Fixtures # of List of Fixtures Fixtures Fi�ctures Toilet Backflow Preventer (Inside Bld ) Bathtub Urinal Lavato (Wash Basin) Drinkin Fountain Shower Floor Drain Kitchen Sink 8� 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 irom the Building Official before being authorized under any circumstance. I am the owner, or I am authorized by the owner of this property to pertorm the work for which application is made, and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. DeAnna Eagle -- � � - - � �oi2�i�s Owner/Authorized Agent Signature Date City of Everett Official Use Only PER IT � � � � _` � O U (Revised 10/12/2015)