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0 PERMIT APPLICATION• <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 I FAX 425-257-8857 1 (E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS:4220 Terrace Dr PROPERTY TAX#: 00497501300300 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Robert Steele TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 4220 Terrace Dr <br /> c,Ty Everett STATE WA 98203 <br /> OWNER PHONE:206-886-9035 OWNER EMAIL: <br /> CONTRACTOR NAME WASHINGTON ENERGY SERVICES <br /> CONTRACTOR ADDRESS: STREET3909 196TH ST SW <br /> CITY LYNNWOOD STATE WA „P 98036 <br /> CONTRACTOR PHONE: 206-378-6648 1 CONTRACTOR EMAIL:vstephenson @Washingtonenegy.COm <br /> CONTRACTOR LICENSE#(REQUIRED):WASH IES851 NS CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 54773 <br /> PRIMARY CONTACT: ❑OWNER IZICONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:206-378-6648 <br /> Vanessa Stephenson iCONTACT EMAIL:vstephenson@washingtonenergy.com <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: I Contract Price of Work: $8400 <br /> Proposed Use of Building: 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 ❑Repair ❑T.l ❑Sin []Sprinkler ❑Demolition ❑Chan e of Use <br /> DESCRIPTION OF WORK: <br /> Installing a ductless heatpump. <br /> ASSOCIATED BUILDING PERMIT#(if a licable): <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 I 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/Mol Other: <br /> SPRINKLER/ SUPPRESSION SYSTEM <br /> Number of Heads <br /> ACKNOWLEDGEMENT.I 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 /> PERMIT# <br /> Vanessa Ste hensOn D 2D1709 by vx 3N sm so" 09/11/17 / 1 { -7D <br /> p Dale.zon os+++303 os St.P <br /> Owner/Authorized Agent Signature Date (Revised 10/12/2015) <br />