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PERMIT APPLICATION <br /> BUILDING / MECHANICAL/PLUMBING I SIGN /SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 FAX 425-257-8857• i(E)everetteps@everettwa.gov i www.everettwa.gov/permits <br /> s, <br /> PROJECT SITE ADDRESS: 1728 95th St SW PROPERTY TAX#: 01008100000200 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER NAME: Eiliot Carnes TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 1728 95th St SW <br /> • <br /> CITY:Everett $TprE,WA zip, 98204 _ <br /> OWNER PHONE:425-348-0852 'OWNER EMAIL:111 <br /> MI r. . t, <br /> CONTRACTOR NAME, Washington Energy Services <br /> CONTRACTOR ADDRESS: STREET 3909 196th .SW ._ <br /> _... CPI'Lynoo�tl" _ STATE WA ZIP 98036 • <br /> CONTRACTOR PHONE: 206-378-6708 CONTRACTOR EMAIL: JCopley@washingtonenergy.com <br /> CONTRACTOR LICENSE#(REQUIRED): WASHIES851NS CITY OF EVERETT BUSINESS LICENSE ( QUIRED):.54773 i <br /> 1 <br /> PRIMARY CONTACT: 0 OWNER ER CONTRACTOR 0 OTHER(Please Specify)- <br /> CONTACT NAME: CONTACT PHONE: 206-378-6708 <br /> Joyce Copley ' <br /> CONTACT EMAIL: JCopley@washingtonenergy.com <br /> Existing Use of Building- Contract Price of Work:$$1,389.00 <br /> Pro.osed Use of Buildin.: Heat Source; ®Gas CI Electric ❑Other__,, _ <br /> Skil ling type: ®SFR-Detached ,OSFR Attached ODupI ❑Mufti-Farm#of Units.: .v ❑Commercial El Industrial <br /> T .e of Pro'ect: El New ❑Addition ❑Remodel ❑Rep$ir'' ❑T.I. ❑Si.n ❑S.rinkler ©Demolition OChange of Use <br /> DESCRIPTION OF WORK: <br /> Replace gas water heater <br /> •SSOCIATED BUILDING PERMIT#(if applicable): <br /> „`; APPLICATION Y .. 1 ,,,vo. ti.ok a° k. <br /> Type of Project: _New T Addn X Alteration _Repair Type of Project: _New ^,-Addn _Alteration _Repair <br /> #of #of #o( #of <br /> List of Fixtures List of Fixtures List of Fixtures List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> 'AIC–Air Handling Units Heat Pump , Toilet, Backflow Preventer(Inside Bldg) <br /> I''Forced Air Systems Unit Heater 'Bathtub Urinal <br /> . <br /> Gas piping <br /> ... Boiler Lavatory(Wash Basin) ,Drinking Fountain <br /> 1Gas Water <br /> Het Refrigeration r . Shower )Floor Drain <br /> qpl , 'Wood Stove "Kitchen Sink&Disposal Grease Trap <br /> Gas Range Ducting Dishwasher Dishwasher Roof Drains <br /> Clothes Oryer`H ltip .Other: Clothes Washer Medical Gas <br /> Range Hood Water Heater Other: <br /> F ( ,.. arIMopletc Other: <br /> xhaust Fan Sink ServiceJB' <br /> � 1 <br /> i rt�li l t b 10 —*- SYSTEM., <br /> ��c..r.�., .. „Elp e - ..,. -.- �-a 'T----- <br /> .. .,, „:. _-s✓ <br /> Number of Heads <br /> ACKNOWLEDGEMENT:f 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,stale,arid tical taw,:The granting of a permit only authorizes approved work and no deviations therefrom,Deviations must first be authorized in writing from the <br /> I building Official before being authorized under any circumstance i am the owner,or tam authorized by the owner of this property to perform the work for which application is made, <br /> trttr o, n ”with the State Crmtractor:s t.ow 18,27 RCW and 286.200A WAC, <br /> City of Everett Official Use Only <br /> l r. 0611111. 6O6— J <br /> LJ9 <br /> Min . '''.0.Agent S3Srteft . ". ale (Revised 111401,15„) <br />