1023 100TH ST SW 2017-03-13 - Laserfiche WebLink

477. PERMIT APPLICATION BUILDING / MECHANICAL / PLUMBING / SIGN / SPRINKLER / DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT SITE ADDRESS:1023 100th St SW PROPERTY TAX#:28041300301400 LEGAL for new construction: Short Plat/subdivision Lot No (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: Jack Drovdahl TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET 1023 100th St SW CITY Everett STATE WA ZIP 98204 OWNER PHONE:425-268-7696 OWNER EMAIL: CONTRACTOR NAME:WASHINGTON ENERGY SERVICES CONTRACTOR ADDRESS: STREET 3909 196TH ST SW C,TY LYNNWOOD STATE WA ZIP 98036 CONTRACTOR PHONE:206-378-6648 CONTRACTOR EMAIL:deagle@washingtonenegy.com CONTRACTOR LICENSE#(REQUIRED):WASHIES851 NS CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 54773 PRIMARY CONTACT: ❑ OWNER nCONTRACTOR ❑ OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:206-378-6648 DeAn na Eagle CONTACT EMAIL:deagle@washingtonenergy.com BUILDING PERMIT APPLICATION Existing Use of Building: Contract Price of Work: $1500 Proposed Use of Building: Heat Source: ❑Gas DElectric DOther Building Type: ❑SFR-Detached ❑SFR-Attached muplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial Type of Project: ❑New ❑Addition DRemodel ERepair ❑T I. DSign ESprinkler ❑Demolition EChange of Use DESCRIPTION OF WORK: Replacing gas water heater ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Type of Project: New Addn Alteration _Repair Type of Project: _New _Addn EAIteration _Repair #of List of Fixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures Fixtures Fixtures Fixtures Fixtures A/C—Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) Forced Air Systems Unit Heater Bathtub Urinal Gas Piping Boiler Lavatory(Wash Basin) Drinking Fountain Water Heater Refrigeration Shower Floor Drain Gas Fireplace Wood Stove Kitchen Sink& Disposal Grease Trap Gas Range Ducting Dishwasher Roof Drains Clothes Dryer Hookups Other: Clothes Washer Medical Gas Range Hood Water Heater Other: Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: SPRINKLER/SUPPRESSION SYSTEM Number of Heads 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 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 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. City of Everett Official Use Only Ethan Onat 01/10/17 PER 1,O I Owner/Authorized Agent Signature Date (Revised 10/12/2015)