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• • <br /> PERMIT APPLICATION <br /> BUILDING / MECHANICAL/ PLUMBING /S1GN 1 SPRINKLER! 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� Nnvw.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFURMATION <br /> PROJECT5ITEADDRESS: 9�9 Rucker Av2 PROPERTYTAX#: 00553217400300 <br /> LEGAL for new construction: Short Plat/subdivision Lot No._ (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNERNAME: L1Sd Gebert TENANTNAME(IfCommercial): <br /> OWNERMAILINGADDRESS: srRFer 909 Rucker AV2 <br /> �,r, Everett Sr�TE Wa �,� 98201 <br /> owNER PHONE: 4 2 5-2 5 9-6 6 5 7 OWNER EMAIL: <br /> CONTRACTOR NAME:BObS Hedting <br /> CONTRACTORADDRESS: sTReer 14148 NE 19Oth St <br /> �in Woodinville sTnTe Wa ziP 98072 <br /> coNTaacTo�taHONe: 800-840-3346 CONTRACTOREMAIL: lhoneycutt@bobsheating. com <br /> CONTRACTOR LICENSE#{REQUIRED); BOBSHHAH S 3NQ CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): O S 4 9 F>7 <br /> PRIMARY CONTACT: ❑OWNER C�CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 2 0 F—3 7 H—C 7 3 5 <br /> Lucinda Honeycutt CONTACTEMAIL: lhoneycutt@bobsheating. com <br /> BUILDfNG PERMIT APPLICATION <br /> Existing Use of Building: S FR Contract Price of Work:$ 2 5 0 0 . 0 <br /> Proposed Use of Building: Heat Source: �Gas ❑Electric ❑Other <br /> Building Type: ❑SFR-Detached C�SFR-Attached ❑Duplex �Multi-Famil -#of Units: ❑Commercial ❑Industrial <br /> T pe of Project: ❑New ❑Addition L�Remodel ❑Repair ❑T.I. ❑Sign ❑S rinkler ❑Demolition ❑Change of Use <br /> DESCRIPTIONOFWORK:like for like furnace replacement <br /> ASSOCIATED BUILDING PERMIT#(if a plicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: New Addn Alteration Repair Type of Project: New Addn Alteration Repair <br /> #of List of Fixtums #of Lisi of Fixtures ��f List of Fixfures ��f List of Fixtures <br /> Fixtuies Fixtures Fixtures Fixtures <br /> A/C—Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) <br /> Forced Air Systems Unit Heater Eiathtub Urinal <br /> Gas Piping Boiler Lavatory(Wash Basin) Drinking Fountain <br /> Water Heater Refrigeration 5hower Floor Drain <br /> Gas Fireplace Wood Stove Kitchen 5ink&Disposal Grease Trap <br /> Gas Range Ducting Dishwasher Roof Drains <br /> Cfothes Dryer Hookups Other. Clothes Washer Medical Gas <br /> Range Flood Water Heater Other: <br /> Exhaust Fan Sink(5ervice/Bar/Map/etr.) Other: <br /> SPRINKLE�2/Sl1PPRESSIOE�1 SYSTEM <br /> Number of Heads <br /> ACKNOWLEDGEMENT:!have reviewed this application and con(irm the information confained herein fs true and correcf.Work done pursuant lo(hls perrnit musf comply wifh <br /> current federal,sfate,and local law.The granting of a permR only authorizes approved wo�k and no deviat%ons tfierefrom.Deviations must first be authorized ih writing from the <br /> Building O(ficial before beiny authaired under any c'rcumstance.I am the owne�,or!am authorized 6y fhe owner of fhis property to pertorm the wort<for which application is made, <br /> and I comply wilh the ate Contractors Law>f3.z/ CW and 296.?.00Fl WAC. <br /> City of Everett Oflicia/Use Only <br /> PERMIT# � ( + <br /> 3/3/17 " � ' �� � I <br /> � <br /> Owner/Authorized Ayent Signature Date (Revisa G�2G/2�16J <br />