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PERMIT APPLICATION <br /> BUILDING � IIIECHANICAL / PLUMBING /SIGN !UI RINKLE�/ C)EMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 � FAX 425-257-8857 � (E)everetteps@everettwa.gov� www.everettwa.govlpermits <br /> PROJECT SITE INFQRMA'TION <br /> PROJECT SITE ADDRESS:2525 PanaV12W BIVCI PROPERTY TAX#:��6�37����28�0 <br /> LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal descriptian; <br /> ca�T�►�T MN�aRnnA�r�c�N �! <br /> OWNER NAME: DOf1aICI HOpI(If1S TENANT NAME(If Commercial): � <br /> OWNER MAILING ADDRESS: sTReET2�J2�J PaflaVl@W BIVCJ <br /> �,n Everett STATE WA ��P 98203 <br /> OWNER PHONE:�425�3rJ9-72O0 OWNER EMAIL: <br /> CONTRACTOR NAME;WASHINGTON ENERGY SERVICES <br /> CONTRACTOR ADDRESS: srREET 3909 196TH ST SW <br /> �,n LYNNWOOD STATE WA 7,� 98036 <br /> CONTRACTOR PHONE:206-378-6648 CONTRACTOR EMAIL:deagle@washingtonene.^,y�.com <br /> CONTRACTOR LICENSE#(REQUIRED):WASHIES851 NS CITY OF EVERETT BUSINESS LIC�NSt#(f�EQUIRE�): �J4773 <br /> PRIMARY CONTACT: ❑ OWNER �CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:206-378-6648 <br /> DeAnna Eagle CONTACTEMAIL:deagle@washingtonenerciy.ccrn <br /> .�'..�.�� <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: Contract Price of Work: $1500 ��1����_ <br /> Proposed Use of Building: Heat Source: ❑Gas ❑Electric ❑Otner <br /> Buildin T e: ❑SFR-Detached ❑SFR-Attached �uplex ❑Multi-Famil -#ofUnits: ❑Comm�a�ciel Glndustrial <br /> T e of Pro ect: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Si n ❑Sprinkler ❑Demolition ❑(� �ar; Ng..of Use <br /> DESCRIPTION OF WORK: <br /> Replacing gas water heater. <br /> ASSOCIATED BUILDING PERMIT# if a licable : <br /> MECHANICAL. PERMIT,APPLICATION PL.UM8ING PERM1�t1�P�.��A,T�ON! <br /> Type of Project: _New _ Addn Alteration _Repair Type of Project: _New Addn �Alt:sratec+� _Repair <br /> #of List of Fixtures #of List of Fixtures #of List of Fixtures #of ����st af Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> A/C—Air Handling Units Heat Pump Toilet Backfi�w Preventer(Inside Bld ) <br /> Forced Air S stems Unit Heater Bathtub Urina! <br /> Gas Pipin Boiler Lavato (Wash Basin) Drin'<�r,g Fountain <br /> � Water Heater Refri eration Shower Floc: �.rair' <br /> Gas Fireplace Wood Stove Kitchen Sink&Disposal GreU:.;e�i rap <br /> Gas Ran e Ductin Dishwasher Roof Drains <br /> Clothes Dr er Hookups Other: Clothes Washer Medical Gas <br /> Ran e Hood Water Heater Other� <br /> Exhaust Fan Sink(Service/Bar/Mop/etc.) Othe:�� <br /> SPRINKLER/SUPPRESSION SYSTEM �' <br /> Number of Heads i � <br /> o���� <br /> ACKNOWLEDGEMENT:I have reviewed this application and confi�m the information contained herein is true and correct. Work done pursuant to�his permit must comply with <br /> current federal,state,and local law. The granting of a permit onty authorizes approved work and no deviations therefrom.Deviations must first b:,:�.thoiized in writing from the <br /> Building Official before being autho�ized under any circumsfance.I am the owner,or 1 am authorized by the owner of this property to perfor,m the viork to�which application is made, <br /> and 1 comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City o;E✓ar".- .1;iicral Use Only <br /> PERMIT�n �� �f������,���� <br /> Griffin Price �.���':'-.._ .. _,. _ .,.......,. aiisi�� j � <br /> Owner/Authorized Agent Signature Date (Revised 10/12/2015) <br />