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PERMIT APPLICATION
<br /> BUILDING / MECHANICAL/ PLUMBING /SIGN /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� www.everettwa.gov/permits
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<br /> PROJECT SITE ADDRESS:2404 B�02dW2y AV@ PROPERTY TAX#:00439154803100
<br /> LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description)
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<br /> OWNER NAME: ROqef WIS@ TENANT NAME(If Commercial):
<br /> OWNER MAILING ADDRESS: srReer2404 Broadway Ave
<br /> ��n Everett STATE WA Z�P 98201
<br /> OWNER PHONE:4252310763 OWNER EMAIL:
<br /> cONTwaCTOR NaME;WASHINGTON ENERGY SERVICES
<br /> CONTRACTOR ADDRESS: srReer 3909 196TH ST SW
<br /> cin LYNNWOOD STATE WA ziP 98036
<br /> CONTRACTOR PHONE:206-378-6648 CONTRACTOR EMAIL:deagle@washingtonenegy.com
<br /> CONTRACTOR LICENSE#(REQUIRED):WASHIES851 NS CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 54'773
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<br /> PRIMARY CONTACT: ❑OWNER �CONTRACTOR ❑OTHER(Please Specify)
<br /> CONTACT NAME: CONTACT PHONE:206-378-6648
<br /> �e{'1n na Eag�e CONTACT EMAIL:deagle@washingtonenergy.com
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<br /> Existin Use of Buildin : Contract Price of Work:$1200
<br /> Pro osed Use of Buildin : Heat Source: ❑Gas ❑Electric ❑Other
<br /> Buildin T e: �SFR-Detached ❑SFR-Attached mu lex �Multi-Famil -#of Units: ❑Commercial ❑Industrial
<br /> T e of Pro'ect: ❑New �Addition ❑Remodel ❑Re air ❑T.I. ❑Si n ❑S rinkler ❑Demolition ❑Chan e of Use
<br /> DESCRIPTION OF WORK:
<br /> Replacing gas water heater
<br /> ASSOCIATED BUILDING PERMIT# if a licable :
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<br /> Type of Project: _New Addn Alteration _Repair Type of Project: _New Addn Iteration _Repair
<br /> #of List of Fi�ctures #of ��st of Fixtures #of List of Fixtures #of List of Fixtures
<br /> Fixtures Fixtures Fixtures Fixtures
<br /> A/C–Air Handlin Units Heat Pump Toilet Backflow Preventer Inside Bltl )
<br /> Forced Air S stems Unit Heater Bathtub Urinal
<br /> Gas Pipin Boiler Lavato Wash Basin Drinkin Fountain
<br /> � Water Heater Refri eration Shower Floor Drain
<br /> Gas Fire lace Wood Stove Kitchen Sink&Dis osal Grease Trap
<br /> Gas Ran e Ductin Dishwasher Roof Drains
<br /> Clothes D er Hooku s Other: Clothes Washer Medical Gas
<br /> Ran e Hood Water Heater Other:
<br /> Exhaust Fan Sink Service/Bar/Mo /etc. Other:
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<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 /> cunent federal,state,and local law. The granting of a permit only authorizes approved work and no deviations therefrom.Deviations must first be authorized in wrding 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 pertorm the work for which application is made,
<br /> and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC.
<br /> City of Everett Official Use Only
<br /> PER IT# � — �
<br /> Ethan Onat ��-��=-d-��^��•��s o5/2s/�7
<br /> Owner/Authorized Agent Signature p� Date (Revised 10/12/2015)
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