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0 PERMIT APPLICATION 0 <br /> BUILDING / MECHANICAL / PLUMBING / SIGN /SPRINKLER / DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> OL 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 1 FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> PROJECT SITZ ; ,N[FORMATION <br /> PROJECT SITE ADDRESS:341 9 Bell Ave PROPERTY TAX#:00561900100900 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Brian Dale TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: sTREET3419 Bell Ave <br /> ciTv Everett STATE WA ZAP <br /> OWNER PHONE:425-258-2268 OWNER EMAIL: <br /> CONTRACTOR NAME WASHINGTON ENERGY SERVICES <br /> CONTRACTOR ADDRESS: ST1EET3909196THSTSW <br /> CITY LYNNWOOD STATE WA ZIP 98036 <br /> CONTRACTOR PHONE:206-378-6644 CONTRACTOR EMAIL:vstephensOn@washingtOnenegy.cOm <br /> CONTRACTOR LICENSE#(REQUIRED):WASHIES851 NS CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 54773 <br /> PRIMARY CONTACT: ❑ OWNER OCONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:206-378-6644 <br /> Vanessa Stephenson CONTACT EMAIL:vstephenson@washingtonenergy.com <br /> BUILDING PERlB[T APPLICATION <br /> Existing Use of Building: Contract Price of W&- $1500 <br /> Proposed Use of Buildin : Heat Source: ❑Gas ❑Electric ❑Other <br /> Building Type: ❑SFR-Detached ❑SFR-Attached duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial <br /> Type of Project: ❑New ❑Addition ❑Remodel ❑Re air ❑T.I. ❑Sin ❑S rinkler ❑Demolition ❑Chan e of Use <br /> DESCRIPTION OF WORK: <br /> Replacing gas water heater. <br /> ASSOCIATED BUILDING PERMIT# if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING;PERMIT APPLICATION <br /> Type of Project: _New _ Addn Alteration Repair Type of Project: New _Addn Iteration 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 /> Water Heater Refrigeration Shower Floor Drain <br /> Gas Fireplace Wood Stove Kitchen Sink& Disposal Grease Trap <br /> Gas Range Ducting Dishwasher Roof Drains <br /> Clothes Dryer Hookups Other: Clothes Washer Medical Gas <br /> Range Hood Water Heater Other: <br /> Exhaust Fan Sink Service/Bar/Mo /etc.) Other: <br /> SPRINKLER/SUPPRESSION 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 am the owner,or I am authorized by the owner of this property to perform the work for which application is made, <br /> and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> PE IT <br /> Vanessa Stephenson „a " 06/08/2017 I <br /> Owner/Authorized Agent Signature Date (Revised 10/12/2015) <br />