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PERMfT APPLICATION <br /> BUILDiNG l MECHANICAL/PLUMBING/SlGN/SPRlNKLER/DEMOLITION <br /> CITY OF'EVERETT PERMIT SERVICES <br /> ' 3200 CEDAR STREET,EVERETT,WA 98201 <br /> {P)425-257-8810 � FAX 425-257-8857 f(E)everettepsLBieverettwa.gov� annvw.everettwa.govlpermits <br /> (Biue or Black lnk Onty Please) `PROJB�T SITE INFCRMATION <br /> PROJECT SITE ADDRESS: 2404 116th St Se PROPERTY TAX#c A0400500000110 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of tong legal descriptionj <br /> CONTACT`iNFORMATtON . <br /> OWNER NAME: Brandon Berg TENANT NAME(If Commerctaq: <br /> OWNEI2 MAILlNG ADDRESS: s�tEer 2404 116th St SE <br /> a�rv Everett srn� Wa z�P 98208 <br /> OWNER PHONE:425-210-8629 OWNER EMAlL: <br /> , . . . ....._. . ..._ _ ._.. .. . .._,_,_. .._. <br /> CON7RACTORNAME; Bobs Heating <br /> CONTRACTOR ADDRESS: srReet 1414 8 NE 19 0 t h S t <br /> ��T. Woodinville srnTe Wa Z,P 98072 <br /> CONTRACTOR PNONE: 8 0 0-8 4 0-3 3 4 6 CONTRACTOR EMAIL: l h o n e y cut t@ b ob s h e a t i n g.com <br /> CC1N"CRACT�}!i L(CENSE i�{FtEGtUiR�k3�:BOB S HHA S S 3 NQ GfTY OF EVERETT BUSINESS LfCEN3E#(REQUIRED): �5 4 9 6� <br /> _ _. .._ _ .__ . ..u._,. �,.. . __.... �..�._.M __..�-- ._. ._.... . ... _ ........ .... ..�__._ _... .., .w _.. __,..,..��_. <br /> PRIMARY CONTACT: ❑OWNER Cffi CDNTF�AC70R CI DTHER(Please Specify} <br /> CONTACTNAME; Lucinda Honeycutt , ' CONTACTPHONE: 206-378-6735 <br /> CONTACT eMA�L: lhoneycutt@bobsheating.com <br /> BUILDfNG PLRMIT APPLICATION <br /> Existing;Use of Buiidin : S FR Contract Price of Work:$ 3900.00 <br /> Proposed Use of Buildin ": Heat Source: C14Gas ❑Electric ❑Other <br /> Bui(din T e; OSFR-Detached L�SFR-Attached ❑Du lex OMuIG-FamU -#of Units: OCommerciai ❑industrial <br /> T e of Pro ect: ❑New �Addition ❑Remodel I�Re afr �T.L ❑SI n ❑S rinkler ❑Demolition ❑Chan e of Use <br /> DESCRIPTION OF WORK: like for like furnace replacement <br /> ASSOCIATED BUILDING PERMIT# if a licable: <br /> MBCHANICAI.PERMIT APALtCAT10N PLUMBlNG PERMIT APPLICATI[!N <br /> Type of Project: _,New_ Addn ,_Aiteration _Repair Type of ProJect: _New �ddn _AlteraUon _Repair <br /> #of #of #of #of <br /> Llst of Fixtures Lisf of F/xtures ' Ltst of Flxturas Llst of Fixtures <br /> Flxtures Flxtures Fixtures Fixfures <br /> A!C—Air Han8liflg Units Heat Pump Toilet Backflow P�eventer Inside Bid ) <br /> 1 F`tsraed At�S, ,tecns I:lnit Fieater Bathtub Urinal <br /> Gas Piping Boiler t�av�to, �'Wasf1 Basfn): Drinking Fountain <br /> Water Heafer Refrigeration Shower Floor D�ain <br /> Gas Fireplaee =. 1Nood Stove Kdtcti�n Sin &[3is asai G�ease Yra <br /> Gas R,�rtge.' ' Ductin ` Dishwasher Roof Dratns <br /> Gtt�fhes,D �r Hcf+�ku ., , Other, Clothes Washer Medicai Gas <br /> [�ange Hoad WaterHeater Other: <br /> Exhaust Fan Sink aervE.ce/E3�idiwtl� 'e#c. ` Qther. <br /> � � � � SPRINKL.ER i SUAPRE�SItaN�YSTENt � � � � � � � <br /> Number of Heads <br /> ACKNOWLEDGEMENT.�!have reviewed fhis applicallon and conHrm the information cantaittad hereln Is trus and correct.Work done pursvant fo th/s permit must comply wrfh <br /> current federal,state,and local iaw.The granNng ol a permlt only autlwrizes approved work and no deViaflons therefrom.Devlations musf first be aufhorized in writing from the <br /> Building Officfai bePore befng authorized underany circumstance,l am the owner,or!am authorize8by ihe owner of thls property to perform the work for whlch app!lcatlon!s made, <br /> artd 1 comply wlfh fhe State Contractors Law 18.27 RCW and 296.200A WAC. <br /> Gify of Everett Ofl7cla!Use Only <br /> ` ..�......�., � <br /> PER� �� L V 1J �� <br /> 10/10/17 � <br /> dwne Authorized Agent Signature Date (Revist�tl W20/207�5) <br />