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PERMIT APPLICATION <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 (E)everetteps@everettwa.gov I www.everettwa.rgov/piirtriits <br /> PROJECT SITE sINFORMATION <br /> PROJECT SITE ADDRESS: 4809 College Ave PROtERTY TAX#` 00606900400200 <br /> LEGAL for new construction: Short PlaUsubdivision_ . _ ,..._� I_of No._ (attach copy of long legal description) <br /> CONTACT':INFORMATION <br /> OWNER NAME: Patti Ormiston TENANT NAME(if Commercial). <br /> OWNER MAILING ADDRESS: STREET 4809 College Ave <br /> cm Everett sTAr= WA zip 98203OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: Washington Energy Services <br /> CONTRACTOR ADDRESS: STREET 3909 196th St.gW <br /> CITY d STATE WA zip 98036 <br /> CONTRACTOR PHONE: 206-378-6927 CONTRACTOR EMAIL: JCopley@washingtonenergy.com <br /> CONTRACTOR LICENSE#(REQUIRED): WASHIES851 NS CITY OF EVERETT BUSINESS LICENSE#(REQUIRED). 54773 <br /> PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR ❑OTHER(Please Specify),. <br /> CONTACT NAME: CONTACT PHONE: 206-378-6708 <br /> Joyce Copley CONTACT EMAIL: JCopley@washingtonenergy.com <br /> �v Nf�t <br /> s' I.I>l LIDIll1 <br /> Existing Use of Buildln : Contract Price of Work: $1500 <br /> Proposed Use of Building: Heat Source: ®Gas ❑Electric ❑Other <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Du lex ❑Multi-Farnil ±of Units:: __ ❑Commercial ❑Industrial <br /> Type of Project: ❑New ❑Addition ❑Remodel ❑Repair, ❑T.I. ❑Stn ❑Sprinkler ❑Demolition ❑Chan e of Use <br /> DESCRIPTION OF WORK: <br /> Replace gas water heater;Tank is in the garage <br /> ASSOCIATED BUILDING PERMIT# if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New _ Addn =Alteration _X_Repair Type of Project: _New _Addn _Alteration _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 /> X Water Heater Refri eration Shower Floor Drain <br /> Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap <br /> Gas Ran e Ducting Dishwasher Rnof 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 I SUPPRE SI[ON SYSTEM <br /> Number of Heads <br /> 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 <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 ant the owner;or t am authorized by the owner of this property to perform the work for which application is made, <br /> and l comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> f� Cityl of Everett Official Use Only <br /> _ T PERMfi. l oq�_ <br /> 95 <br /> Ows ut oozed AgetSltinatui' Dat (Revised 112/1"015) <br />