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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 <br /> ,. <br /> e���<� ��`.,,,, s� `X, �� '�� r��`r'�` �/�ii � �„xi �^ x ��.. <br /> < .�. <br /> �__ , ,- i �„: ... _., a.:.. :: ,.. <br /> ,.. :.... . <br /> PROJECT SITE ADDRESS:2�6 ��9th St SE PROPERTY TAX#:��6765�0���800 <br /> LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br /> ���w ���� -��. 1�1T#�,�, � � � � � ` � ; �� <br /> ,y�� � �� � „�x �.�,.,� <br /> OWNER NAME: LOCI KOIIatII TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: srReeT2O6 �O9tI1 St SE <br /> �,n Everett STATE WA Z�P 98208 <br /> OWNER PHONE:�6OS�2�9-OZ43 OWNER EMAIL: <br /> CONTRACTOR NAME,WASHINGTON ENERGY SERVICES <br /> CONTRACTOR ADDRESS: srReer 3909 196TH ST SW <br /> crn LYNNWOOD ST,,TE 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) 773 <br /> _,,.b.p_..,.❑... � ... _. ... _.._. ,o. ....... . .... ,. <br /> PRIMARY CONTACT: ❑OWNER �/ CONTRACTOR ❑OTHER(Please Speci ) <br /> CONTACT NAME: CONTACT PHONE:206-378-6648 <br /> �eAn na Eag�e CONTACT EMAIL:deagle@wash� nenergy.com <br /> � �,hf.�� �� ��I.� G.: �Rl���''�,��!►�I.IC,r�T��7► �. ;�$a ,� ,� ,' �� �,. <br /> Existin Use of Buildin : Contract Price of Wo :$14 0 <br /> Proposed Use of Buildin : Heat Source: ❑Gas ❑Electr ❑Other <br /> Buildin T e: ✓❑SFR-Detached ❑SFR-Attached mu lex �Multi-Famil -#of Units: ❑Commercial ❑Industrial <br /> T e of Pro'ect: ❑New ❑Addition ❑Remodel ❑Re air ❑T.I. ❑Si n ❑S rinkler Demolition ❑Chan e of Use <br /> DESCRIPTION OF WORK: <br /> Replacing electric water heater. Electric to electric tank. <br /> ASSOCIATED BUILDING PERMIT# if a licable : <br /> ����. ��,��M�CA� t����MMT� � :; a ��►�'I�I�A� �� , <br /> Type of Project: _New_ Addn Alteration Repair Type of Project: New Addn ✓ Iteration Repair <br /> #of List of Fixtures #°f List of Fixtures #of List of Fixtures #of List of Fixtures <br /> Fixtures Fixtures Fixtures Fi�ctures <br /> AIC—Air Handlin Units Heat Pump Toilet Backflow Preventer(Inside Bld ) <br /> Forced Air S stems Unit Heater Bathtub Urinal <br /> Gas Pipin Boiler Lavato (Wash Basin) Drinkin Fountain <br /> Water Heater Refri eration Shower Floor Drain <br /> Gas Fire lace Wood Stove Kitchen Sink&Disposal Grease Trap <br /> Gas Ran e Ductin Dishwasher Roof Drains <br /> Clothes D er Hooku s Other: Clothes Washer Medical Gas <br /> Ran e Hood Water Heater Other: <br /> Exhaust Fan Sink Service/Bar/Mo /etc. Other: <br /> ,,.� ,. .... <br /> 1'�.��E���'�PR�S�y,$ � :� <br /> . , . <br /> Number of Heads <br /> ACKNOWLEDGEMENT.�I have reviewed this application and cronfirm 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 pertorm the work for which application is made, <br /> and 1 compfy with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> ���s;.a���.E.�..��� PE � # c S - a5 3 <br /> Griffin Price 5/23/17 <br /> Owner/Authorized Agent Signaturep�� Date (Revised 10/12/2015) <br />