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477 PERMIT APPLICATIOI <br /> BUILDING / MECHANICAL/ PLUMBING /SIGN / SPRINKLER/ DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I (E)everetteps@everettwa.gov l www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS:7004 Beverly Blvd PROPERTY TAX#:00392800100501 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Maiya Truby TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET7004 Beverly Blvd <br /> CITY Everett STATE WA ZIP 98203 <br /> OWNER PHONE:425-870-6939 OWNER EMAIL: <br /> CONTRACTOR NAME:WASHINGTON ENERGY SERVICES <br /> CONTRACTOR ADDRESS: STREET 3909 196TH ST SW <br /> c,n LYNNWOOD STATE WA Z,P 98036 <br /> CONTRACTOR PHONE:206-378-6648 CONTRACTOR EMAIL:deagle@WaShingtOnenegy.COm <br /> CONTRACTOR LICENSE#(REQUIRED):WASH IES851 NS CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 54773 <br /> PRIMARY CONTACT: ❑OWNER (CONTRACTOR CI OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:206-378-6648 <br /> DeAnna Eagle CONTACT EMAIL:deagle@washingtonenergy.com <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building:111 Single Family Residence - Detached Contract Price of Work: $1358.35 <br /> Proposed Use of Building: Heat Source: CIGas ❑Electric DOther <br /> Building Type: ❑SFR-Detached ❑SFR-Attached Ibuplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial <br /> Type of Project ❑New DAddition DRemodel DRepair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition DChange of Use - <br /> DESCRIPTION OF WORK: <br /> 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 EAlteration _Repair <br /> #of List of Fixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> A/C—Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) <br /> Forced Air Systems Unit Heater Bathtub Urinal <br /> Gas Piping Boiler Lavatory(Wash Basin) Drinking Fountain <br /> Water Heater Refrigeration Shower Floor Drain <br /> Gas Fireplace Wood Stove Kitchen Sink& Disposal Grease Trap <br /> Gas Range Ducting Dishwasher Roof Drains <br /> Clothes Dryer Hookups Other: Clothes Washer Medical Gas <br /> Range Hood Water Heater Other: <br /> Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: <br /> SPRINKLER/SUPPRESSION SYSTEM' <br /> Number of Heads <br /> 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 <br /> 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 <br /> 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, <br /> and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> PERM n <br /> DeAnna Eagle 11/02/16 01,) <br /> Owner/Authorized Agent Signature Date (Revised 10/12/2015) <br />