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To: E Page 2 of 5 2016-03-14 20:00:35 (GMT) 18884000383 From: Deborah Shields <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/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: 1 31 1 H OYT AVE PROPERTY TAX#00438524500500 PEMT# <br /> LEGAL for new construction: Short Platisubdivision Lot No. (attach copy of long legal description) <br /> OWNERKIM NIELSEN Phone/E-mail <br /> Address 1311 HOYT AVE City/State2ip EVERETT, WA 98201 <br /> APPLICANT: Owner Owner's Agent _Contractor ✓ Contractor's Agent _Tenant(must prooi7e a later of consent from the weer to do work in the sil <br /> CONTRACTOR WaShington Energy SVCS Co, LLC state Lic.#WASHI ES851 NS City Bus. Lic.# 054773 <br /> Address 3909 196th St SW, Lynnwood, WA 98036 Phone/Email800-398-4663 <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 1,3RO R3 <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gas[%/l Electric Other <br /> Building type: Wkingle Family Duple ownhouseFamily Commercial <br /> Type of project: New Addition Remodel Raire T.I. Sin Sprinkler Demolition Chane of Use <br /> DESCRIPTION OF WORK(additional space provided on tale back): <br /> REPLACE GAS WATER HEATER <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project Ne ddn Iteration^Repair Type of ProjectENe ddr V 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 piping Lavatory wash basin <br /> Water heater j Shower <br /> Gas fireplace Kitchen sink&disposal <br /> i <br /> Gas range Dishwasher <br /> i Clothes dryer I Clothes washer <br /> Range hood 1 i Water heater <br /> Exhaust fan Sink (service/bar/mop/etc.) <br /> Heat pump I Backflow preventer <br /> Unit heater Urinal <br /> j Boiler <br /> Drinking Fountain <br /> I <br /> Refrigeration Floor drain <br /> I Woodstove Grease trap <br /> Ducting Roof drains <br /> Other i Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM <br /> Other: <br /> Number of Heads I 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 glue authority to violate or cancel the provision of any other state or local law regulating construction <br /> That 1 at�w d ti .� . rot this RroQ,?,rty to p�ih���lr ecyvorkjo,which application is made and I comply with the State Contractors Law 18.27 RCw and 296.200A WAC, <br /> 7 <br /> ON r—Jn i E uvnll v. v. <br /> �'" >C�Sh.�,, eln tl-ler uelg i��aurtc n -�s 03/14/2016 <br /> Oat, 20 W.14 tc s ,a-0709 <br /> Owner/Authorized Agent Signature Date (Revised 9/2014) <br /> OD <br />