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PERMIT APPLICATION <br /> BUIL.DING!M�CHANIGAL.1 PLUMBING!SIGN !SPRINKLER/DEMOLI7I�N <br /> CITY QF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> {P)425-257-8810 � FAX 42b-257-8857 �(E)everetteps(�evereftwa.gov� wu+w.everettwa.govlpermits <br /> Blue or Black Ink Only Plsase PROJ8C7 31TE INPGRMATION <br /> PROJECT SITE ADDRESS: 2020 113th PI Se PROPER7Y TAX#: 01148000100600 <br /> LEGAL for new construction: Short Piat/suhdivision Lot Na (attach copy of long Iegal description} <br /> CONTACT INFORMATION <br /> OWNER NAME: Paul Forney 7ENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: sTrteEr 2020 113th PI SE <br /> c�rv Everett STATE Wa z�P 98208 <br /> OWNER PHONE: 706-399-3787 OWNER EMAIL: <br /> _ <br /> CON7RACTORNAME; Bobs Heating <br /> CONTRACTOR ADDRESS: srReer 1414 8 NE 19 0 th S t <br /> cm WOodinville STATE Wa z1P 98072 <br /> coNTtucroRaHONe: 800-840-3346 CONTRACTOREMAIL: lhoneycutt@bobsheating.com <br /> GDNT'RAGTOt't LICENSE#[Ft�QtJIR�t3):BOB S HHA8 5 3NQ �tTY OF EVERETT BUSINESS LICENSE#(itEQUIRED): O S 4 9 F>� <br /> _ _ . _ __ . . __. _ _ _, . _... _. _ __ _, ._ .. ___ <br /> PRIMARY CONTACT: ❑OWNER �CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACTNAMEs Lucinda Honeycutt CONTAGTPHQNE: 206-378-6735 <br /> CONTACTEMAIL: lhoneycutt@bobsheating.com <br /> BUILQIN6 PHRMIT APPLICATIQN <br /> Existin Use of Buildfn : S FR Cont�act Prtce oi Work:$ 8500.00 <br /> Pro osed Use of Bullding: Heat Source: �Gas [�lectrlc ❑Other <br /> Buiidin T e: ❑SFR-betached ❑SFR-Attached ❑Du lex ❑Multi-Famil -#of Units: ❑Commercial ❑Industrial <br /> T e of ProJect: ❑New �Addit(on ❑Remodel ❑Re afr ❑T.I. ❑Si n ❑S rinkler ❑Demolition ❑Chan e of Use <br /> DESCRIPTION OF WORK: add ductless heat pump <br /> ASSOCIATED BUILQING PERMIT# if a licabte: <br /> MECHANICAL PERMIT APPLtCAT10N PLUMBING PERMIT APPLICATION <br /> Type of Project: New Addn _Alterafion _Repair Type of ProJect: _New _�4ddn �Alteration _Repair <br /> Flxfu es ��si of Flxtures Flxtures Llsf of Flxtures Fixtures List of Flxtures F��uY� Lisi of Flxtures <br /> A/C–Air Handling Units 1 Heat Pump Toilet Backflow Preventer Inside Bldg) <br /> Forced Aic S. stem� Unit Heater Bathtub Urinal <br /> Gas Piping Boiler Lauakory(Wash Basin) Drinking Fountain <br /> Water Heater Ref�igeration Shower Floor Drain <br /> Gas Fireplace Wood Stove Kitchen Sink&C3is osal Grease Tra <br /> Gas Range Ducting Dtshwasi�er Roof Dratns <br /> Glafhes D er Mookups Other. Clothes Washer Medical Gas <br /> R�nge Hoad Water Neater Other: <br /> Exhaust Fan Sink Sa�vice/Baril�Aoptetc� Other: <br /> SPRINKLER/SUPPR�SSItaN SYSTBM <br /> Number of Heads <br /> ACKNOWLEDGEMENT.•f heve revlewed thts appNcallon and conllrm the inlo�maHon contalned hereln Is true and coirack Work done pursuattt to thls parmit must comply wiih <br /> current Pederal,stafe,end loca!law.The grenNng o(a permR only authodzes approved work and no devladons therefrom.Devlaflons must firsf be authorized!n wrlting from the <br /> Bulld/ng Officia!belore be(ng authorized under any clrcumstance.I am the owner,or I am authorized by the owner of thls properly to perform the work for whlch appllcaBon Is made, <br /> antl i cromply wlth he State Contractors w i8.27 RCW and 296.200A WAC. <br /> Glty of Everett Ofllcfal Use Only <br /> PE I � <br /> 8/8/17 — <br /> Owner/A orized Agent Stgnature bate (Revised f�20/2Uf6) <br />