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417-7- • PERMIT APPLICATIO <br /> N ORIGI <br /> BUILDIN / ECHANICAL/ PLUMBING /SIGN <br /> /SPRINKLER / DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I (E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: PROPERTY TAX#: <br /> 311 TRENTON PL 0047630000100 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME:SUSAN G HALL TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 311 TRENTON PL <br /> CITY EVERETT STATE WA ZIP 98208 <br /> OWNER PHONE: 425-353-1348 OWNER EMAIL: <br /> CONTRACTOR NAME: BLUE FLAME HEATING AND AIR CONDITIONING <br /> CONTRACTOR ADDRESS: STREET 7116 220TH ST SW,SUITE 1 <br /> CITY MOUNTLAKE TERRACE STATE WASHINGTON ZIP 98043 <br /> CONTRACTOR PHONE: 425-771-7139 CONTRACTOR EMAIL: INFO@BLUEFLAMECOMFORT.COM <br /> CONTRACTOR LICENSE#(REQUIRED): BLUEFFH865JB CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): f .'j G <br /> PRIMARY CONTACT: El OWNER cil CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 425-771-7139 <br /> NAQUIN GRAY CONTACT EMAIL: NGRAY@BLUEFLAMECOMFORT.COM <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: RESIDENTIAL Contract Price of Work:$ 9345.00 <br /> Proposed Use of Building: RESIDENTIAL Heat Source: DGas EElectric DOther <br /> Building Type: ®SFR-Detached DSFR-Attached DDuplex DMulti-Family-#of Units: DCommercial ❑Industrial <br /> Type of Project: ❑New ®Addition ❑Remodel ❑Repair DT.I. ❑Sign ❑Sprinkler ❑Demolition DChange of Use <br /> DESCRIPTION OF WORK: <br /> LIKE AND KIND FURNACE CHANGE-OUT WITH HEAT PUMP INSTALLATION <br /> ASSOCIATED BUILDING PERMIT# (if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New X Addn _Alteration _Repair Type of Project: _New Addn _Alteration _Repair <br /> Fixtures List of Fixtures Fixtures List of Fixtures #of List of Fixtures #of List of Fixtures <br /> Fixtures Fixtures <br /> 1 A/C–Air Handling Units 1 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 /> — <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/Mop/etc.) 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 rth the State Contractor Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> mature <br /> �' ,-- 2/23/17 (Owner/A rized AgentDate (Revised 10/12/2015) <br />