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PERMIT APPLICATION <br /> BUILDING I MECHANICAL/PLUMBING /SIGN/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.govtpermits ` <br /> 1728 95th St SW <br /> PROJECT SITE ADDRESS: PROPERTY TAX#: 01008100000200 <br /> • <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> y <br /> OWNER NAME: Elliot Carnes TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 172895th St SW <br /> CITY Everett STATE:WA , ZIP 98204 <br /> OWNER PHONE:425-348-0852 OWNER EMAIL: <br /> CONTRACTOR NAME Washington Energy Services <br /> CONTRACTOR ADDRESS: STREET 3909 196th Si.SW <br /> CITY Lynri STATE WA. ZIP 98036 <br /> CONTRACTOR PHONE: 206-378-6708 CONTRACTOR EMAIL: JCopley@washingtonenergy.com <br /> CONTRACTOR LICENSE#(REQUIRED): WASHIES851NS CITY OF EVERETT BUSINESS LICENSER QUIIRED) 54773 <br /> PRIMARY CONTACT: 0 OWNER ®CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 206-378-6708 <br /> Joyce Copley4 <br /> CONTACT EMAIL: JCopley@washingtonenergy.com <br /> Existing Use of Building:- Contract Price of Work:$ $1,389.00 <br /> Proposed Use of Building: Heat Source: ®Gas ❑Electric ❑Other <br /> .1Building-T'ypea ISFR-Detached DSFR-Attached ❑Duplex ❑Multi-Famlty of Liras: ❑Commercial ❑industrial <br /> 'Tape of Project ONew ❑Addition ❑Remodel ❑RepairDTI ❑Sign ❑Sprinkler ❑Demolition ❑Change,of Use <br /> DESCRIPTION OF WORK: <br /> Replace gas water heater in garage <br /> ASSOCIATED BUILDING PERMIT#cif applicable): <br /> .ME ..! ,'-r AL{I APP NCAtt; t.v ,,g�°, a <br /> Type of Project: New ,+ Addn X Alteration Repair Type of Project: New _,,Addn _Alteration _Repair i <br /> #of #of #of' #of <br /> List of Fixtures List of Fixtures List of Fixtures List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> 'A/C—Air Handling Units 1-ieat Pum Toilet BackflowwPreventer(Inside Bldg) <br /> I Forced Air Systems Unit Heater Bathtub , Urinal <br /> I Gas <br /> iHieater Boiler` y(Wsh Basin) Drinking Fountain <br /> 1 Water <br /> *Refrigeration Shower Floor Drain <br /> - Gas.Freplt,tde Wood Stove ,Kitchen Sink&Disposal Grease Trap <br /> Gas Range ` ' Ducting Dishwasher Roof Drains <br /> Clothes ,erliotkup Other Clothes Washer Medical Gas <br /> Range Hood Water Heater Other <br /> Exhaust Fan Sink(ServicelBartMap/etchOther: <br /> s1P4 RIS SESSION,Se if$1! M+1` ,: <br /> Number of Heads <br /> ACKNOWLEDGEMENT:i have reviewed this application and confirm the information contained herein is true and correct.Work done pursuant to this permit must comply with <br /> current federal,state,and local law.The granting of a permit only authorizes approved work and no deviations therefrom,Deviations must first be authorized in writing from the <br /> Building Official before being authorized under any circumstance,I are the owner,or 1 am authorized by the owner of this properly to perform the work for which application is made; <br /> • "I,"with the State m;nntractors law 18,27 ROW and 296,2004 WAG. <br /> City of Overall Official Use Qntjq <br /> .. z <br /> f PERMIT# <br /> d,i14 <, 06101!1x, , p"" l ( 0(Q - O0� <br /> m o$-; <br />