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PERMIT APPLICATIO <br /> BUILDING�ECHANICAL / PLUMBING /SIGN /� RINKLER/ DEMOLITION <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 /> PROJEGT SITE IMF+C?RMATIf�N <br /> PROJECT SITE ADDRESS: 1617 ROCk@f8112f AV@ PROPERTY TAX#:00438233800800 <br /> LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br /> ``CCINTAGT IN�QRNIATIDN <br /> OWNER NAME: �aCTI@S Bf00I(S TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: sTReer 1617 ROCk@f@Ilef AVe <br /> CITY Everett STATE v v� ZIP 98201 <br /> OWNER PHONE:425-220-4947 OWNER EMAIL: <br /> CONTRACTOR NAME;WASHINGTON ENERGY SERVICES <br /> CONTw4CTOR ADDRESS: sTREET 3909 196TH ST SW <br /> �,n LYNNWOOD STATE WA Z,P 98036 <br /> CONTRACTOR PHONE:206-378-6648 CONTRACTOR EMAIL:deagle@washingtonenegy.com <br /> CONTRACTOR LICENSE#(REQUIRED):WASHIES851 NS CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 54773 <br /> PRIMARY CONTACT: ❑ OWNER �CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:206-378-6648 <br /> DeAn na Eag le CONTACT EMAIL:deagle@washingtonenergy.com <br /> BUILDING RERMIT APPLICAT�dN <br /> Existing Use of Building: Contract Price of Work:$ �4,000 <br /> Proposed Use of Building: Heat Source: ❑Gas ❑Electric ❑Other <br /> Buildin T pe: ❑SFR-Detached ❑SFR-Attached �u lex ❑Multi-Famil -#of Units: ❑Commercial ❑Industrial <br /> T pe of Proect: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Si n ❑S rinkler ❑Demolition ❑Chan e of Use <br /> DESCRIPTION OF WORK: <br /> Replacing gas furnace like in kind. Installing a new gas fireplace insert <br /> and running gas piping. Installing a tankless water heater and running <br /> ASSOCIATED BUILDING PERMIT# if a licable gaS plping. <br /> MECHANICAL, PERMIT APPL.IGATION PI,.UMBING PERMIT APP�MCATIQN <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 ��st of Fixtures #of List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> A/C—Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bld ) <br /> � Forced Air Systems Unit Heater Bathtub Urinal <br /> z Gas Pipin Boiler Lavato (Wash Basin) Drinkin Fountain <br /> � Water Heater Refri eration Shower Floor Drain <br /> i Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap <br /> Gas Ran e Ductin Dishwasher Roof Drains <br /> Clothes Dryer Hookups Other: Clothes Washer Medical Gas <br /> Ran e Hood � ea Other: <br /> Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: <br /> SPRINKLER/SUPPRESSION SYSTEM <br /> Number of Heads <br /> ACKNOWLEDGEMENT:l 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 loca/law. The granting of a permit only authorizes approved work and no deviations therefrom.Deviations must first 6e authorized in writing f�om the <br /> Building Official befo�e being authorized under any circumstance. I am the owner,or I am authorized 6y the owner of this p�operty to perform the work for which app/ication is made, <br /> and/comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> PE T# �� DL� <br /> Ethan Onat c=-w�.-.,-�.--.•��-.m�•�= 12i08i16 <br /> Owner/Authorized Agent Signature Date (Revised 10/1 15) <br />