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To: E Page 4 of 5 2016-03-14 20:00:35 (GMT) 18884000383 From: Deborah Shields <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLU MBING/SIGN/SPRIN KLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> SITE ADDRESS:5011 HARBOR LN PROPERTY TAX ft00732800000400 PERMIT# <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER PAUL DENNIS Phone/E-mail <br /> Address 5011 HARBOR LN city/state/Zip EVERETT, WA 98203 <br /> APPLICANT:—Owner _Owner's Agent _Contractor ✓Contractor'sAgent Tenant(Pust provide a letter of consent from the ovAier to do work in the space) <br /> CONTRACTOR Washington Energy Svcs Co, LLC State Lic.#WASHI ES851 NS City Bus. Lic.# 054773 <br /> Address3909 196th St SW, Lynnwood, WA 98036 IlPhoriefErnail 800-398-4663 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Jennifer Covello/jennifer@nwpermit.com 206-774-9499 <br /> Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 4730 40 <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building GasW I Other <br /> Building type: Wkingle Family Duplex ownhouseFamily Commercial <br /> Type of project: New Addition Remodel Re air T.I. Sin Sprinkler Demolition Chane of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> REPLACE GAS WATER HEATER <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of ProjectNe ddnE:l Iteration_,Repair Type of ProjectE] ddr ✓ Alteration_Repair <br /> Show Number # of fixtures Show Number # of fixtures <br /> A/C–air handling units Toilet <br /> Forced airs stems Bathtub <br /> Gas pipingLavatory wash basin) <br /> Water heater Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood 1 Water heater <br /> Exhaust fan Sink (service/bar/mop/etc.) <br /> Heat pumpBackflow preventer <br /> Unit heater Urinal <br /> i <br /> Boiler <br /> Drinking Fountain <br /> ! <br /> Refrigeration Floor drain <br /> I Woodstove Grease trap <br /> Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER/ SUPPRESSION SYSTEM Other: <br /> Number of Heads ! Other: <br /> I hereby certify that I have read and examined this application and know the same to be true and correct.All provisions of laws and ordinances governing this type of work will be comp <br /> with whether specified herein or not.The granting of a permit does not presume to give authority to violate or cancel the provision of any other state or local law regulating construction <br /> That I ar`",A t r of IM4 Rr0�Quty to p�ri��mii eCyVOtkiofo,which application is made and I comply with the Slato Contractors Law 1 B.27 RCW and 296.200A WAC. <br /> DN r-J r E eil o �u. <br /> rr lc r c-US 03/14/2016 <br /> oal,. 2016Qat_;r,,a C7 JrJ <br /> Owner/Authorized Agent Signature Date (Revised 912094) <br />